Provider First Line Business Practice Location Address:
2 COLLEGE AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
MOUNTVILLE
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
17554-1546
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
717-285-7443
Provider Business Practice Location Address Fax Number:
717-285-3555
Provider Enumeration Date:
10/23/2006