Provider First Line Business Practice Location Address:
44 E MAIN ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
MOUNT UNION
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
17066-1356
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
717-724-4136
Provider Business Practice Location Address Fax Number:
717-635-6176
Provider Enumeration Date:
12/29/2010