Provider First Line Business Practice Location Address:
340 S LIBERTY ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
ORWIGSBURG
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
17961-2127
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
570-366-5096
Provider Business Practice Location Address Fax Number:
570-366-8755
Provider Enumeration Date:
07/24/2006