Provider First Line Business Practice Location Address:
1205 S 28TH ST
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:
17111-1046
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
717-565-7000
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
06/26/2009