Provider First Line Business Practice Location Address:
8105 ADAMS DR STE B
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
HUMMELSTOWN
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
17036-8625
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
717-482-8115
Provider Business Practice Location Address Fax Number:
717-482-8364
Provider Enumeration Date:
08/03/2006