Provider First Line Business Practice Location Address:
1022 N UNION ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
MIDDLETOWN
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
17057-2158
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
717-944-0491
Provider Business Practice Location Address Fax Number:
717-944-1436
Provider Enumeration Date:
03/31/2006