Provider First Line Business Practice Location Address:
34 SCHOOLHOUSE RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
ST THOMAS
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
17252
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
717-369-2946
Provider Business Practice Location Address Fax Number:
717-369-5683
Provider Enumeration Date:
02/28/2006