Provider First Line Business Practice Location Address:
3 W. MONUMENT SQ.
Provider Second Line Business Practice Location Address:
SUITE 206
Provider Business Practice Location Address City Name:
LEWISTOWN
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
17044
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
717-248-8197
Provider Business Practice Location Address Fax Number:
717-248-6449
Provider Enumeration Date:
08/03/2006