Provider First Line Business Practice Location Address:
100 S FRONT ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
LIVERPOOL
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
17045
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
717-444-3413
Provider Business Practice Location Address Fax Number:
717-444-3421
Provider Enumeration Date:
10/12/2005