Provider First Line Business Practice Location Address:
44 CARROLLS TRACT RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
FAIRFIELD
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
17320-9439
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
717-752-5882
Provider Business Practice Location Address Fax Number:
717-642-9027
Provider Enumeration Date:
11/07/2006