Provider First Line Business Practice Location Address:
3 BADEN POWELL LN
Provider Second Line Business Practice Location Address:
SUITE 4
Provider Business Practice Location Address City Name:
MECHANICSBURG
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
17050-5270
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
717-766-1566
Provider Business Practice Location Address Fax Number:
717-766-2604
Provider Enumeration Date:
10/04/2006