Provider First Line Business Practice Location Address:
4310 N GEORGE STREET EXT
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
MANCHESTER
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
17345-1307
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
717-978-5142
Provider Business Practice Location Address Fax Number:
717-978-5126
Provider Enumeration Date:
12/08/2015