Provider First Line Business Practice Location Address:
200 S. PROGRESS AVENUE
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:
17710-4638
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
717-526-4889
Provider Business Practice Location Address Fax Number:
717-671-9149
Provider Enumeration Date:
05/05/2009