Provider First Line Business Practice Location Address:
156 HIGH POINTE DR
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
HUMMELSTOWN
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
17036-8104
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
315-447-6212
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
03/27/2026