Provider First Line Business Practice Location Address:
144 PUGH DRIVE
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
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
717-532-7338
Provider Business Practice Location Address Fax Number:
717-530-8338
Provider Enumeration Date:
05/13/2010