Provider First Line Business Practice Location Address:
162 NEWARK ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
LITTLESTOWN
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
17340-1208
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
717-359-4146
Provider Business Practice Location Address Fax Number:
717-359-9617
Provider Enumeration Date:
05/23/2008