Provider First Line Business Practice Location Address:
16 E MAIN ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
ELIZABETHVILLE
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
17023-2001
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
717-496-5998
Provider Business Practice Location Address Fax Number:
717-905-2453
Provider Enumeration Date:
05/27/2019