Provider First Line Business Practice Location Address:
4813 JONESTOWN RD
Provider Second Line Business Practice Location Address:
SUITE 103
Provider Business Practice Location Address City Name:
HARRISBURG
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
17109-1700
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
717-671-5070
Provider Business Practice Location Address Fax Number:
717-671-5075
Provider Enumeration Date:
06/08/2006