Provider First Line Business Practice Location Address:
532 N FRONT ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
WORMLEYSBURG
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
17043-1016
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
717-761-4141
Provider Business Practice Location Address Fax Number:
717-761-1456
Provider Enumeration Date:
11/14/2008