Provider First Line Business Practice Location Address:
305 FOURT ST
Provider Second Line Business Practice Location Address:
PLEASANT ACRES
Provider Business Practice Location Address City Name:
LEWISTOWN
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
17044-1399
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
717-242-0367
Provider Business Practice Location Address Fax Number:
717-242-0369
Provider Enumeration Date:
12/29/2006