Provider First Line Business Practice Location Address:
38-42 NORTH LONDONDERRY SQUARE
Provider Second Line Business Practice Location Address:
ROUTE 422
Provider Business Practice Location Address City Name:
PALMYRA
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
17078-0000
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
717-838-6050
Provider Business Practice Location Address Fax Number:
717-838-6907
Provider Enumeration Date:
09/12/2006