Provider First Line Business Practice Location Address:
291 S 4TH ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
COLUMBIA
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
17512-1731
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
717-684-9000
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
08/23/2012