Provider First Line Business Practice Location Address:
SOUTH 4TH STREET
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
DENVER
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
17517-0800
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
717-336-1423
Provider Business Practice Location Address Fax Number:
717-336-1418
Provider Enumeration Date:
08/02/2006