Provider First Line Business Practice Location Address:
1629 S MARKET ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
ELIZABETHTOWN
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
17022-2852
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
717-361-8699
Provider Business Practice Location Address Fax Number:
717-361-7978
Provider Enumeration Date:
11/27/2018