Provider First Line Business Practice Location Address:
5351 LINCOLN HWY
Provider Second Line Business Practice Location Address:
SUITE 2
Provider Business Practice Location Address City Name:
GAP
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
17527-9468
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
717-442-1300
Provider Business Practice Location Address Fax Number:
717-442-1064
Provider Enumeration Date:
09/13/2006