Provider First Line Business Practice Location Address:
21 N STATE ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
EPHRATA
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
17522-2738
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
717-721-9717
Provider Business Practice Location Address Fax Number:
717-721-7683
Provider Enumeration Date:
03/16/2006