Provider First Line Business Practice Location Address:
2805 OLD POST RD STE 210
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
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
717-540-1051
Provider Business Practice Location Address Fax Number:
717-540-3804
Provider Enumeration Date:
06/30/2006