Provider First Line Business Practice Location Address:
92 TUSCARORA ST
Provider Second Line Business Practice Location Address:
2ND FLOOR
Provider Business Practice Location Address City Name:
HARRISBURG
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
17104-1667
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
717-233-2020
Provider Business Practice Location Address Fax Number:
717-233-0825
Provider Enumeration Date:
08/15/2005