Provider First Line Business Practice Location Address:
5431 JONESTOWN RD
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:
17112-4062
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
717-540-8448
Provider Business Practice Location Address Fax Number:
717-540-6233
Provider Enumeration Date:
02/16/2007