Provider First Line Business Practice Location Address:
2 SOUTH MARKET STREET
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
MILLERSTOWN
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
17062-0129
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
717-589-3361
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
04/26/2007