Provider First Line Business Practice Location Address:
1323 N FRONT ST
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:
17102-2629
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
717-917-8693
Provider Business Practice Location Address Fax Number:
717-589-9901
Provider Enumeration Date:
05/06/2009