Provider First Line Business Practice Location Address:
5050 JONESTOWN RD
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:
17112-2921
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
717-652-9190
Provider Business Practice Location Address Fax Number:
717-671-8369
Provider Enumeration Date:
02/12/2010