Provider First Line Business Practice Location Address:
624 COLEBROOK RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
MIDDLETOWN
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
17057-3905
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
717-439-7955
Provider Business Practice Location Address Fax Number:
717-948-1628
Provider Enumeration Date:
09/04/2006