Provider First Line Business Practice Location Address:
24 ANTRIM COMMONS DR
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:
17225-1623
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
717-597-5553
Provider Business Practice Location Address Fax Number:
717-597-5522
Provider Enumeration Date:
02/11/2019