Provider First Line Business Practice Location Address:
150 KEMPTON AVE
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:
17111-3543
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
717-558-7771
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
09/16/2010