Provider First Line Business Practice Location Address:
101 FRONT ST.
Provider Second Line Business Practice Location Address:
BOX 189
Provider Business Practice Location Address City Name:
BOILING SPRINGS
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
17007-0189
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
717-240-0019
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
02/05/2008