Provider First Line Business Practice Location Address:
2433 C OLD PHILADELPHIA PIKE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SMOKETOWN
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
17576
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
717-291-6035
Provider Business Practice Location Address Fax Number:
717-291-5538
Provider Enumeration Date:
09/06/2006