Provider First Line Business Practice Location Address:
20 N SHERIDAN RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
NEWMANSTOWN
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
17073-9102
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
610-589-2455
Provider Business Practice Location Address Fax Number:
610-589-2555
Provider Enumeration Date:
09/23/2005