Provider First Line Business Practice Location Address:
900 S ARLINGTON AVE RM 144B
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:
17109-5030
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
717-370-4976
Provider Business Practice Location Address Fax Number:
717-412-7390
Provider Enumeration Date:
03/18/2020