Provider First Line Business Practice Location Address:
24 N MAIN ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
LEWISTOWN
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
17044-1745
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
717-242-3070
Provider Business Practice Location Address Fax Number:
717-248-4424
Provider Enumeration Date:
03/21/2006