Provider First Line Business Practice Location Address:
279 WEST MAIN STREET
Provider Second Line Business Practice Location Address:
#8
Provider Business Practice Location Address City Name:
MIDDLETOWN
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
17057-1222
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
717-944-0004
Provider Business Practice Location Address Fax Number:
717-944-7710
Provider Enumeration Date:
05/25/2006