Provider First Line Business Practice Location Address:
722 STATE ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
LEMOYNE
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
17043-1536
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
717-737-7831
Provider Business Practice Location Address Fax Number:
717-763-0959
Provider Enumeration Date:
07/27/2006