Provider First Line Business Practice Location Address:
2647 N 6TH ST
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:
17110-2641
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
717-236-9094
Provider Business Practice Location Address Fax Number:
717-236-9052
Provider Enumeration Date:
08/10/2006