Provider First Line Business Practice Location Address:
4309 LINGLESTOWN RD
Provider Second Line Business Practice Location Address:
SUITE 105-E
Provider Business Practice Location Address City Name:
HARRISBURG
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
17112-8624
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
717-545-7252
Provider Business Practice Location Address Fax Number:
717-545-7272
Provider Enumeration Date:
05/16/2007