Provider First Line Business Practice Location Address:
4210 LINGLESTOWN 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:
17112-1025
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
717-540-9218
Provider Business Practice Location Address Fax Number:
717-545-3127
Provider Enumeration Date:
09/28/2009