Provider First Line Business Practice Location Address:
4808 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:
17109-1701
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
717-526-8401
Provider Business Practice Location Address Fax Number:
717-526-8404
Provider Enumeration Date:
07/22/2005