Provider First Line Business Practice Location Address:
24 E WILLIAM ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SCHUYLKILL HAVEN
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
17972-1715
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
570-573-2922
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
10/17/2005