Provider First Line Business Practice Location Address:
2793 OLD POST RD
Provider Second Line Business Practice Location Address:
SUITE 11
Provider Business Practice Location Address City Name:
HARRISBURG
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
17110-3683
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
717-480-1002
Provider Business Practice Location Address Fax Number:
717-412-7136
Provider Enumeration Date:
10/17/2013