Provider First Line Business Practice Location Address:
1000 BRIARSDALE RD STE C
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:
17109-5901
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
717-558-3500
Provider Business Practice Location Address Fax Number:
717-558-3505
Provider Enumeration Date:
12/19/2006