Provider First Line Business Practice Location Address:
6100 OLD JOHNSTOWN 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
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
717-541-0988
Provider Business Practice Location Address Fax Number:
717-541-8838
Provider Enumeration Date:
01/20/2006