Provider First Line Business Practice Location Address:
111 S FRONT STREET
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
HARRISBURG
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
17110-2010
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
717-782-5590
Provider Business Practice Location Address Fax Number:
717-782-5581
Provider Enumeration Date:
06/14/2005