Provider First Line Business Practice Location Address:
3320 RIDGEWAY 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:
17109-1023
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
717-652-3881
Provider Business Practice Location Address Fax Number:
717-541-0317
Provider Enumeration Date:
04/14/2006