Provider First Line Business Practice Location Address:
FOURTH AND WALNUT STREETS
Provider Second Line Business Practice Location Address:
ATTN: RADIOLOGY DEPARTMENT
Provider Business Practice Location Address City Name:
LEBANON
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
17042-1281
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
717-270-7645
Provider Business Practice Location Address Fax Number:
717-270-7596
Provider Enumeration Date:
05/24/2006