Provider First Line Business Practice Location Address:
4 W WATER 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:
17044-2141
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
717-242-4403
Provider Business Practice Location Address Fax Number:
717-242-4416
Provider Enumeration Date:
08/31/2006