Provider First Line Business Practice Location Address:
322 W HIGH ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
ELIZABETHTOWN
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
17022-2140
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
254-291-7313
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
06/24/2010