Provider First Line Business Practice Location Address:
217 S MAIN ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
MANHEIM
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
17545-2201
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
717-664-1570
Provider Business Practice Location Address Fax Number:
717-664-1571
Provider Enumeration Date:
10/30/2007