Provider First Line Business Practice Location Address:
24 JAMES AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
LITTLESTOWN
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
17340-1108
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
717-359-5723
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
10/31/2007