Provider First Line Business Practice Location Address:
119 W MAIN ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
NEW HOLLAND
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
17557-1203
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
717-354-6471
Provider Business Practice Location Address Fax Number:
717-354-0701
Provider Enumeration Date:
04/20/2007