Provider First Line Business Practice Location Address:
152 E MARKET ST
Provider Second Line Business Practice Location Address:
SUITE 200
Provider Business Practice Location Address City Name:
LEWISTOWN
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
17044-2160
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
717-242-4840
Provider Business Practice Location Address Fax Number:
717-242-4841
Provider Enumeration Date:
02/05/2016