Provider First Line Business Practice Location Address:
2901 N SIXTH STREET
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:
17102
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
717-236-3126
Provider Business Practice Location Address Fax Number:
717-920-5426
Provider Enumeration Date:
09/22/2006