Provider First Line Business Practice Location Address:
4025 N PROGRESS AVE
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:
17110-9528
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
717-232-7509
Provider Business Practice Location Address Fax Number:
717-232-6687
Provider Enumeration Date:
02/19/2008