Provider First Line Business Practice Location Address:
800 S 12TH ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
LEBANON
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
17042-6903
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
717-273-8170
Provider Business Practice Location Address Fax Number:
717-274-7526
Provider Enumeration Date:
02/15/2021