Provider First Line Business Practice Location Address:
1149 HARRISBURG PIKE
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:
17013-1607
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
814-937-4614
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
02/21/2010