Provider First Line Business Practice Location Address:
47 BROOKWOOD AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
CARLISLE
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
17015-9266
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
717-243-2236
Provider Business Practice Location Address Fax Number:
717-243-6536
Provider Enumeration Date:
07/30/2006