Provider First Line Business Practice Location Address:
105 OLD YORK ROAD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
NEW CUMBERLAND
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
17070-2485
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
717-774-0261
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
10/12/2006