Provider First Line Business Practice Location Address:
522 LOCUST RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
NEW CUMBERLAND
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
17070-3139
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
717-932-6101
Provider Business Practice Location Address Fax Number:
717-932-4424
Provider Enumeration Date:
03/27/2006