Provider First Line Business Practice Location Address:
300 E 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:
17036-1725
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
717-566-6486
Provider Business Practice Location Address Fax Number:
717-566-8548
Provider Enumeration Date:
05/30/2008