Provider First Line Business Practice Location Address:
110 N 7TH ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
LEMOYNE
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
17043-1501
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
717-731-6094
Provider Business Practice Location Address Fax Number:
717-731-6199
Provider Enumeration Date:
07/25/2006