Provider First Line Business Practice Location Address:
407 S 2ND ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
WRIGHTSVILLE
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
17368-1605
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
717-553-0281
Provider Business Practice Location Address Fax Number:
717-843-3222
Provider Enumeration Date:
01/30/2007