Provider First Line Business Practice Location Address:
14961 BUCHANAN TRAIL EAST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
BLUE RIDGE SUMMIT
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
17214
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
717-762-9118
Provider Business Practice Location Address Fax Number:
717-762-2860
Provider Enumeration Date:
12/06/2006