Provider First Line Business Practice Location Address:
310 ELECTRIC AVE STE 230
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:
717-248-7512
Provider Business Practice Location Address Fax Number:
717-248-2710
Provider Enumeration Date:
02/27/2007