Provider First Line Business Practice Location Address:
70 SCHOOL HOUSE RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
ST THOMAS
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
17252-9674
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
717-369-3123
Provider Business Practice Location Address Fax Number:
717-369-3183
Provider Enumeration Date:
06/04/2006