Provider First Line Business Practice Location Address:
200 N 5TH 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:
17512-2102
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
717-684-2283
Provider Business Practice Location Address Fax Number:
717-681-2220
Provider Enumeration Date:
04/26/2006