Provider First Line Business Practice Location Address:
107 EAST MAIN ST.
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
LANDISBURG
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
17040-0165
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
717-789-2118
Provider Business Practice Location Address Fax Number:
717-789-2118
Provider Enumeration Date:
02/17/2010