Provider First Line Business Practice Location Address:
222 S MARKET ST
Provider Second Line Business Practice Location Address:
SUITE 104
Provider Business Practice Location Address City Name:
ELIZABETHTOWN
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
17022-2439
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
717-779-6639
Provider Business Practice Location Address Fax Number:
717-361-9100
Provider Enumeration Date:
06/21/2013