Provider First Line Business Practice Location Address:
20 E BURD ST STE 1
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SHIPPENSBURG
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
17257-1328
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
717-477-2556
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
10/03/2019