Provider First Line Business Practice Location Address:
405 E SUNBURY ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
MILLERSTOWN
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
17062-9528
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
717-589-3115
Provider Business Practice Location Address Fax Number:
717-589-3013
Provider Enumeration Date:
05/13/2006