Provider First Line Business Practice Location Address:
1586 SUMNEYTOWN PIKE
Provider Second Line Business Practice Location Address:
PO BOX 198
Provider Business Practice Location Address City Name:
KULPSVILLE
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
19443
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
203-497-3861
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
08/27/2025