Provider First Line Business Practice Location Address:
711 S 8TH ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
LEBANON
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
17042-6750
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
717-272-2252
Provider Business Practice Location Address Fax Number:
717-272-5842
Provider Enumeration Date:
12/29/2005