Provider First Line Business Practice Location Address:
24082 ROUTE 35 N
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
MIFFLINTOWN
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
17059-7926
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
717-436-6844
Provider Business Practice Location Address Fax Number:
717-436-6644
Provider Enumeration Date:
09/21/2012