Provider First Line Business Practice Location Address:
214 PEACH ORCHARD RD STE 100
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
MC CONNELLSBURG
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
17233-8559
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
717-485-3622
Provider Business Practice Location Address Fax Number:
717-485-5176
Provider Enumeration Date:
01/25/2007