Provider First Line Business Practice Location Address:
1305 MIDDLETOWN RD
Provider Second Line Business Practice Location Address:
SUITE1
Provider Business Practice Location Address City Name:
HUMMELSTOWN
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
17036-8825
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
717-566-3776
Provider Business Practice Location Address Fax Number:
717-566-2243
Provider Enumeration Date:
01/26/2007