Provider First Line Business Practice Location Address:
3601 N. PROGRESS AVE
Provider Second Line Business Practice Location Address:
SUITE 100, 201
Provider Business Practice Location Address City Name:
HARRISBURG
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
17110
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
717-233-7290
Provider Business Practice Location Address Fax Number:
717-233-5334
Provider Enumeration Date:
07/13/2005