Provider First Line Business Practice Location Address:
505 ELECTRIC AVE
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:
17044-1126
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
717-242-4476
Provider Business Practice Location Address Fax Number:
717-242-8558
Provider Enumeration Date:
05/03/2006