Provider First Line Business Practice Location Address:
40 2ND ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
HIGHSPIRE
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
17034-1002
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
717-939-4975
Provider Business Practice Location Address Fax Number:
717-939-3596
Provider Enumeration Date:
01/24/2011