Provider First Line Business Practice Location Address:
110 S 1ST ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
MC CONNELLSBURG
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
17233-1308
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
717-485-3404
Provider Business Practice Location Address Fax Number:
717-485-3878
Provider Enumeration Date:
05/18/2009