Provider First Line Business Practice Location Address:
310 ELECTRIC AVE
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:
17044-1369
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
717-242-2531
Provider Business Practice Location Address Fax Number:
717-242-1028
Provider Enumeration Date:
07/28/2011