Provider First Line Business Practice Location Address:
463 E MAIN AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
MYERSTOWN
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
17067-2226
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
717-272-4967
Provider Business Practice Location Address Fax Number:
717-564-3135
Provider Enumeration Date:
02/20/2007