Provider First Line Business Practice Location Address:
701 N MOUNTAIN 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:
17112-2373
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
717-695-3540
Provider Business Practice Location Address Fax Number:
717-307-3514
Provider Enumeration Date:
09/16/2008