Provider First Line Business Practice Location Address:
1600 ROXBURY RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SHIPPENSBURG
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
17257
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
717-532-7771
Provider Business Practice Location Address Fax Number:
717-532-0015
Provider Enumeration Date:
12/02/2016