Provider First Line Business Practice Location Address:
220 E LEHMAN ST
Provider Second Line Business Practice Location Address:
MR TARGETED SERVICE MANAGEMENT
Provider Business Practice Location Address City Name:
LEBANON
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
17046-3930
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
717-274-3415
Provider Business Practice Location Address Fax Number:
717-274-0317
Provider Enumeration Date:
04/16/2007