Provider First Line Business Practice Location Address:
12 W CHURCH ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
REAMSTOWN
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
17567
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
717-336-3958
Provider Business Practice Location Address Fax Number:
717-336-2364
Provider Enumeration Date:
08/03/2005