Provider First Line Business Practice Location Address:
278 INDUSTRIAL PARK RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
POTTSVILLE
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
17901-9126
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
570-429-1900
Provider Business Practice Location Address Fax Number:
570-429-1166
Provider Enumeration Date:
10/16/2006