Provider First Line Business Practice Location Address:
1561 STATE ROUTE 209
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
MILLERSBURG
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
17061-8217
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
717-692-2161
Provider Business Practice Location Address Fax Number:
717-692-2162
Provider Enumeration Date:
09/02/2006