Provider First Line Business Practice Location Address:
626 S. MARKET STREET
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
ELIZABETHTOWN
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
17022
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
717-361-7414
Provider Business Practice Location Address Fax Number:
717-361-7443
Provider Enumeration Date:
12/17/2009