Provider First Line Business Practice Location Address:
201 EIGHTH ST - HIGHLAND PARK
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
LEWISTOWN
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
17044
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
717-248-0148
Provider Business Practice Location Address Fax Number:
717-248-5345
Provider Enumeration Date:
05/20/2006