Provider First Line Business Practice Location Address:
615 MOUNTAIN HOUSE RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
HALIFAX
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
17032-7723
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
717-827-2142
Provider Business Practice Location Address Fax Number:
717-827-2174
Provider Enumeration Date:
03/27/2007