Provider First Line Business Practice Location Address:
255 N 6TH ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
COLUMBIA
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
17512-2107
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
717-684-3228
Provider Business Practice Location Address Fax Number:
717-684-0302
Provider Enumeration Date:
05/19/2006