Provider First Line Business Practice Location Address:
3309 SPRING ST
Provider Second Line Business Practice Location Address:
SUITE 201
Provider Business Practice Location Address City Name:
HARRISBURG
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
17109-3629
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
717-574-2224
Provider Business Practice Location Address Fax Number:
717-238-4181
Provider Enumeration Date:
04/04/2007