Provider First Line Business Practice Location Address:
701 E KING ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SHIPPENSBURG
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
17257
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
717-530-1527
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
09/07/2006