Provider First Line Business Practice Location Address:
542 BRIDGE ST
Provider Second Line Business Practice Location Address:
SUITE A
Provider Business Practice Location Address City Name:
NEW CUMBERLAND
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
17070-1957
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
717-561-9988
Provider Business Practice Location Address Fax Number:
717-909-5982
Provider Enumeration Date:
08/08/2006