Provider First Line Business Practice Location Address:
2 S MARKET ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
MILLERSTOWN
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
17062-9780
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
717-622-5903
Provider Business Practice Location Address Fax Number:
717-622-5913
Provider Enumeration Date:
09/07/2016