Provider First Line Business Practice Location Address:
303 WALNUT ST
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:
17101-1803
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
717-257-7921
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
09/06/2005