Provider First Line Business Practice Location Address:
400 PINE BROOK PL
Provider Second Line Business Practice Location Address:
SUITE 2
Provider Business Practice Location Address City Name:
ORWIGSBURG
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
17961-2350
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
570-366-0300
Provider Business Practice Location Address Fax Number:
570-366-3999
Provider Enumeration Date:
03/30/2006