Provider First Line Business Practice Location Address:
4811 JONESTOWN RD
Provider Second Line Business Practice Location Address:
ST 129
Provider Business Practice Location Address City Name:
HARRISBURG
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
17109-1745
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
717-526-2011
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
03/18/2007