Provider First Line Business Practice Location Address:
301 S PENN ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SHIPPENSBURG
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
17257-8717
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
717-477-2105
Provider Business Practice Location Address Fax Number:
717-477-5174
Provider Enumeration Date:
06/11/2018