Provider First Line Business Practice Location Address:
5008 LENKER ST
Provider Second Line Business Practice Location Address:
STE 101
Provider Business Practice Location Address City Name:
MECHANICSBURG
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
17050-1925
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
717-919-6124
Provider Business Practice Location Address Fax Number:
717-814-3133
Provider Enumeration Date:
12/11/2006