Provider First Line Business Practice Location Address:
1952 LIMESTONE DR
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
HUMMELSTOWN
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
17036-7023
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
717-309-1665
Provider Business Practice Location Address Fax Number:
717-566-2384
Provider Enumeration Date:
12/25/2007