Provider First Line Business Practice Location Address:
2570 INTERSTATE DR
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:
17110-9601
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
717-541-0651
Provider Business Practice Location Address Fax Number:
717-541-0758
Provider Enumeration Date:
01/30/2007