Provider First Line Business Practice Location Address:
515 SPRUCE ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
MIDDLETOWN
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
17057-2050
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
864-494-2776
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
01/13/2025