Provider First Line Business Practice Location Address:
50 N 12TH ST
Provider Second Line Business Practice Location Address:
GROUND LEVEL
Provider Business Practice Location Address City Name:
LEMOYNE
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
17043-1428
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
717-612-9790
Provider Business Practice Location Address Fax Number:
717-612-9846
Provider Enumeration Date:
07/04/2006