Provider First Line Business Practice Location Address:
106 S 4TH ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
HALIFAX
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
17032-9037
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
717-896-3385
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
05/25/2007