Provider First Line Business Practice Location Address:
611 ELECTRIC AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
LEWISTOWN
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
17044-1128
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
717-242-2714
Provider Business Practice Location Address Fax Number:
717-242-3020
Provider Enumeration Date:
03/07/2006