Provider First Line Business Practice Location Address:
44 NORTH FIFTH STREET
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
MOUNT WOLF
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
17347
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
717-266-3631
Provider Business Practice Location Address Fax Number:
717-266-6751
Provider Enumeration Date:
09/06/2006