Provider First Line Business Practice Location Address:
340 LUMBER ST
Provider Second Line Business Practice Location Address:
SUITE B
Provider Business Practice Location Address City Name:
LITTLESTOWN
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
17340-1668
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
717-359-5300
Provider Business Practice Location Address Fax Number:
717-359-0775
Provider Enumeration Date:
11/21/2005