Provider First Line Business Practice Location Address:
2977 STATE ROUTE 22
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
FREDERICKSBURG
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
17026-9304
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
717-865-6566
Provider Business Practice Location Address Fax Number:
717-865-1664
Provider Enumeration Date:
09/02/2006