Provider First Line Business Practice Location Address:
423 N 21ST ST
Provider Second Line Business Practice Location Address:
SUITE 100
Provider Business Practice Location Address City Name:
CAMP HILL
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
17011-2207
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
717-761-0930
Provider Business Practice Location Address Fax Number:
717-761-0465
Provider Enumeration Date:
10/27/2010