Provider First Line Business Practice Location Address:
700 SOUTH 12TH STREET
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
LEBANON
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
17042-6901
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
717-272-3079
Provider Business Practice Location Address Fax Number:
717-228-1404
Provider Enumeration Date:
12/26/2008