Provider First Line Business Practice Location Address:
291 E MAIN ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
HUMMELSTOWN
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
17036-1723
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
717-566-5318
Provider Business Practice Location Address Fax Number:
717-566-3670
Provider Enumeration Date:
05/18/2006