Provider First Line Business Practice Location Address:
601 N MOUNTAIN 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:
17112-2371
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
717-652-8940
Provider Business Practice Location Address Fax Number:
717-652-8945
Provider Enumeration Date:
03/23/2006