Provider First Line Business Practice Location Address:
5360 LINCOLN HIGHWAY EAST, STORE #15
Provider Second Line Business Practice Location Address:
VILLAGE AT GAP
Provider Business Practice Location Address City Name:
GAP
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
17527-9461
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
717-442-8111
Provider Business Practice Location Address Fax Number:
717-442-8981
Provider Enumeration Date:
07/01/2006