Provider First Line Business Practice Location Address:
717 MARKET ST.
Provider Second Line Business Practice Location Address:
SUITE 112
Provider Business Practice Location Address City Name:
LEMOYNE
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
17043
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
717-703-3937
Provider Business Practice Location Address Fax Number:
717-703-5715
Provider Enumeration Date:
07/21/2006