Provider First Line Business Practice Location Address:
1800 LINGLESTOWN RD
Provider Second Line Business Practice Location Address:
SUITE 308
Provider Business Practice Location Address City Name:
HARRISBURG
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
17110-3347
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
717-233-4944
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
05/05/2006