Provider First Line Business Practice Location Address:
500 NORTH UNION STREET
Provider Second Line Business Practice Location Address:
SUITE 205
Provider Business Practice Location Address City Name:
MIDDLETOWN
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
17057-1950
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
717-944-2225
Provider Business Practice Location Address Fax Number:
179-440-9327
Provider Enumeration Date:
07/21/2006