Provider First Line Business Practice Location Address:
5 E MAIN ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SHIREMANSTOWN
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
17011-6310
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
717-761-6023
Provider Business Practice Location Address Fax Number:
717-730-0928
Provider Enumeration Date:
05/13/2006