Provider First Line Business Practice Location Address:
1254 EAST EARL RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
EAST EARL
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
17519-0100
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
717-354-7904
Provider Business Practice Location Address Fax Number:
717-354-0754
Provider Enumeration Date:
09/06/2006