Provider First Line Business Practice Location Address:
3 W 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:
17011-6327
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
717-761-4373
Provider Business Practice Location Address Fax Number:
717-761-4503
Provider Enumeration Date:
03/03/2009