Provider First Line Business Practice Location Address:
899 POPLAR CHURCH RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
CAMP HILL
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
17011-2206
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
717-763-0430
Provider Business Practice Location Address Fax Number:
717-763-9854
Provider Enumeration Date:
06/14/2005