Provider First Line Business Practice Location Address:
1101 MARKET 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:
17103-2225
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
717-234-7931
Provider Business Practice Location Address Fax Number:
717-234-1779
Provider Enumeration Date:
05/16/2016