Provider First Line Business Practice Location Address:
93 PROGRESS BLVD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SHIPPENSBURG
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
17257-9595
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
717-532-3211
Provider Business Practice Location Address Fax Number:
717-532-3099
Provider Enumeration Date:
10/02/2006