Provider First Line Business Practice Location Address:
500 N 12TH ST STE 300
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:
17043-1241
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
717-230-1630
Provider Business Practice Location Address Fax Number:
717-230-1635
Provider Enumeration Date:
06/01/2011