Provider First Line Business Practice Location Address:
10 VALLEY ST
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:
17044-1851
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
717-248-1153
Provider Business Practice Location Address Fax Number:
717-248-2726
Provider Enumeration Date:
12/14/2006