Provider First Line Business Practice Location Address:
12 WEST FIFTH ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
QUARRYVILLE
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
17566
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
717-786-7201
Provider Business Practice Location Address Fax Number:
717-786-2359
Provider Enumeration Date:
02/01/2007