Provider First Line Business Practice Location Address:
31 S DORCAS ST
Provider Second Line Business Practice Location Address:
COMPASS BLDG. SUITE E
Provider Business Practice Location Address City Name:
LEWISTOWN
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
17044-2110
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
717-447-1898
Provider Business Practice Location Address Fax Number:
717-447-1891
Provider Enumeration Date:
06/30/2005