Provider First Line Business Practice Location Address:
2107 CASTLEGREEN DR
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
GREENCASTLE
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
17225-9215
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
717-597-2978
Provider Business Practice Location Address Fax Number:
717-597-3046
Provider Enumeration Date:
05/15/2007