Provider First Line Business Practice Location Address:
2805 OLD POST RD
Provider Second Line Business Practice Location Address:
SUITE 110
Provider Business Practice Location Address City Name:
HARRISBURG
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
17110-3675
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
717-635-2030
Provider Business Practice Location Address Fax Number:
717-635-2029
Provider Enumeration Date:
11/06/2012