Provider First Line Business Practice Location Address:
424 NYE ROAD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
HUMMELSTOWN
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
17036
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
717-533-0428
Provider Business Practice Location Address Fax Number:
717-533-1050
Provider Enumeration Date:
04/23/2007