Provider First Line Business Practice Location Address:
211 3RD STREET
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
LEWISTOWN
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
17044
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
717-242-7297
Provider Business Practice Location Address Fax Number:
717-242-7741
Provider Enumeration Date:
04/27/2015