Provider First Line Business Practice Location Address:
1 E MILL ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
ELYSBURG
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
17824-9683
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
570-672-2920
Provider Business Practice Location Address Fax Number:
570-672-9505
Provider Enumeration Date:
06/21/2005