Provider First Line Business Practice Location Address:
49 BROOKWOOD AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
CARLISLE
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
17013-9126
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
717-258-1462
Provider Business Practice Location Address Fax Number:
717-258-8164
Provider Enumeration Date:
06/27/2005