Provider First Line Business Practice Location Address:
282 W MAIN ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
ELIZABETHVILLE
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
17023-8827
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
717-362-3371
Provider Business Practice Location Address Fax Number:
717-362-4278
Provider Enumeration Date:
07/18/2007