Provider First Line Business Practice Location Address:
110 LOWTHER ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
LEMOYNE
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
17043-2012
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
717-774-2202
Provider Business Practice Location Address Fax Number:
717-774-2634
Provider Enumeration Date:
09/27/2006