Provider First Line Business Practice Location Address:
215 W MAIN ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
HUMMELSTOWN
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
17036-1420
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
717-566-8786
Provider Business Practice Location Address Fax Number:
717-566-8702
Provider Enumeration Date:
09/20/2007