Provider First Line Business Practice Location Address:
23 N BROWN ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
LEWISTOWN
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
17044-1734
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
717-248-4984
Provider Business Practice Location Address Fax Number:
717-248-4985
Provider Enumeration Date:
01/30/2007