Provider First Line Business Practice Location Address:
175 SAINT THOMAS EDENVILLE RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SAINT THOMAS
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
17252-9743
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
717-369-3174
Provider Business Practice Location Address Fax Number:
717-369-4084
Provider Enumeration Date:
12/19/2006