Provider First Line Business Practice Location Address:
456 E CUMBERLAND ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
LEBANON
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
17042-8118
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
717-926-1166
Provider Business Practice Location Address Fax Number:
717-272-2326
Provider Enumeration Date:
11/09/2005