Provider First Line Business Practice Location Address:
689 YORKTOWN RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
LEWISBERRY
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
17339-9258
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
717-932-3830
Provider Business Practice Location Address Fax Number:
717-932-3839
Provider Enumeration Date:
06/23/2009