Provider First Line Business Practice Location Address:
219 N BALTIMORE AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
MOUNT HOLLY SPRINGS
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
17065-1204
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
717-486-8606
Provider Business Practice Location Address Fax Number:
717-486-4410
Provider Enumeration Date:
08/30/2006