Provider First Line Business Practice Location Address:
20 E BURD ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SHIPPENSBURG
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
17257-1328
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
717-220-8980
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
05/15/2020