Provider First Line Business Practice Location Address:
618 CUMBERLAND ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
LEBANON
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
17042-5232
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
717-274-2741
Provider Business Practice Location Address Fax Number:
717-274-5405
Provider Enumeration Date:
09/21/2005