Provider First Line Business Practice Location Address:
161 OLD SCHOOLHOUSE LN
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
MECHANICSBURG
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
17055-5684
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
717-697-4002
Provider Business Practice Location Address Fax Number:
717-697-7810
Provider Enumeration Date:
03/19/2007