Provider First Line Business Practice Location Address:
105 WEST FRONT STREET
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
LEWISBERRY
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
17339
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
717-938-2801
Provider Business Practice Location Address Fax Number:
717-938-4453
Provider Enumeration Date:
05/12/2009