Provider First Line Business Practice Location Address:
100 S HIGH ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
NEWVILLE
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
17241-1409
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
717-776-3114
Provider Business Practice Location Address Fax Number:
717-776-6003
Provider Enumeration Date:
12/28/2006