Provider First Line Business Practice Location Address:
1820 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:
17110-3339
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
717-236-7482
Provider Business Practice Location Address Fax Number:
717-236-7485
Provider Enumeration Date:
05/24/2006