Provider First Line Business Practice Location Address:
146 S ANTRIM WAY
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
GREENCASTLE
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
17225-1522
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
717-597-2115
Provider Business Practice Location Address Fax Number:
717-597-2116
Provider Enumeration Date:
03/31/2006