Provider First Line Business Practice Location Address:
172 TEACREEK RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
REEDSVILLE
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
17084-8719
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
717-250-6434
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
12/30/2011