Provider First Line Business Practice Location Address:
951 CLEEK AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
LANDISVILLE
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
17538-1605
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
717-892-3511
Provider Business Practice Location Address Fax Number:
717-892-3512
Provider Enumeration Date:
10/26/2005