Provider First Line Business Practice Location Address:
689 YORKTOWN RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
LEWISBERRY
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
17339-9258
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
717-932-4050
Provider Business Practice Location Address Fax Number:
717-932-8072
Provider Enumeration Date:
12/14/2006