Provider First Line Business Practice Location Address:
4033 E NEWPORT RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
KINZERS
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
17535-9718
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
717-768-5510
Provider Business Practice Location Address Fax Number:
717-768-5628
Provider Enumeration Date:
10/07/2009