Provider First Line Business Practice Location Address:
36 S RIVER RD LOWR LEVEL
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
HALIFAX
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
17032-8614
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
717-827-3306
Provider Business Practice Location Address Fax Number:
717-827-3292
Provider Enumeration Date:
06/23/2006