Provider First Line Business Practice Location Address:
319 S 10TH 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:
17043-1708
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
717-566-5025
Provider Business Practice Location Address Fax Number:
717-566-5026
Provider Enumeration Date:
08/17/2010