Provider First Line Business Practice Location Address:
33 E SIMPSON ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
MECHANICSBURG
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
17055-3816
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
717-697-0551
Provider Business Practice Location Address Fax Number:
717-795-8395
Provider Enumeration Date:
06/13/2005