Provider First Line Business Practice Location Address:
340 WAYBURN ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
GREENCASTLE
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
17225-1554
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
717-360-4767
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
10/16/2009