Provider First Line Business Practice Location Address:
150 W FULTON ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
EPHRATA
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
17522-1937
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
717-738-4901
Provider Business Practice Location Address Fax Number:
717-738-1259
Provider Enumeration Date:
03/06/2007