Provider First Line Business Practice Location Address:
34 N BALTIMORE AVE
Provider Second Line Business Practice Location Address:
APT. 1
Provider Business Practice Location Address City Name:
MOUNT HOLLY SPRINGS
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
17065-1328
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
717-486-7873
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
04/14/2007