Provider First Line Business Practice Location Address:
182 BUCHANAN TRAIL,
Provider Second Line Business Practice Location Address:
SUITE: 150
Provider Business Practice Location Address City Name:
MCCONNELLSBURG
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
17233
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
717-485-3724
Provider Business Practice Location Address Fax Number:
717-485-5924
Provider Enumeration Date:
11/06/2006