Provider First Line Business Practice Location Address:
2459 WALNUT ST
Provider Second Line Business Practice Location Address:
N/A
Provider Business Practice Location Address City Name:
HARRISBURG
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
17103-1750
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
717-712-2951
Provider Business Practice Location Address Fax Number:
717-695-0979
Provider Enumeration Date:
09/22/2009