Provider First Line Business Practice Location Address:
20 COLLEGE AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
ELIZABETHTOWN
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
17022
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
717-367-8234
Provider Business Practice Location Address Fax Number:
717-367-1884
Provider Enumeration Date:
01/03/2008