Provider First Line Business Practice Location Address:
247 E 3RD ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
LEWISTOWN
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
17044-1712
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
717-248-2506
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
11/13/2006