Provider First Line Business Practice Location Address:
46 WALNUT BOTTOM RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SHIPPENSBURG
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
17257-8219
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
717-530-5117
Provider Business Practice Location Address Fax Number:
717-262-4593
Provider Enumeration Date:
05/23/2006