Provider First Line Business Practice Location Address:
201 E. LAUREL BLVD
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
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
570-628-4444
Provider Business Practice Location Address Fax Number:
570-628-3088
Provider Enumeration Date:
08/04/2011