Provider First Line Business Practice Location Address:
10889 PLUM ST.
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
HARMONSBURG
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
16422-0366
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
814-382-7782
Provider Business Practice Location Address Fax Number:
814-382-7782
Provider Enumeration Date:
11/21/2006