Provider First Line Business Practice Location Address:
15 EAST BIG SPRING ROAD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
NEWVILLE
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
17241
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
717-776-4747
Provider Business Practice Location Address Fax Number:
717-776-9321
Provider Enumeration Date:
04/19/2006