Provider First Line Business Practice Location Address:
1216 MT CARMEL RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
ORRTANNA
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
17353
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
717-253-6859
Provider Business Practice Location Address Fax Number:
717-338-9093
Provider Enumeration Date:
12/09/2008