Provider First Line Business Practice Location Address:
11368 WILLIAMSPORT PIKE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
GREENCASTLE
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
17225-8531
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
717-593-4633
Provider Business Practice Location Address Fax Number:
717-593-4632
Provider Enumeration Date:
08/10/2006