Provider First Line Business Practice Location Address:
3 WALNUT ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
LEMOYNE
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
17043-1168
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
717-232-9593
Provider Business Practice Location Address Fax Number:
717-234-9638
Provider Enumeration Date:
06/14/2005