Provider First Line Business Practice Location Address:
4319 LONDONDERRY RD
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:
17109-5318
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
717-541-1400
Provider Business Practice Location Address Fax Number:
717-541-8080
Provider Enumeration Date:
08/30/2006