Provider First Line Business Practice Location Address:
465 W MAIN ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
MOUNTVILLE
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
17554-1918
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
717-285-2300
Provider Business Practice Location Address Fax Number:
717-285-5978
Provider Enumeration Date:
10/04/2006