Provider First Line Business Practice Location Address:
890 POPLAR CHURCH RD
Provider Second Line Business Practice Location Address:
SUITE 208
Provider Business Practice Location Address City Name:
CAMP HILL
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
17011-2250
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
717-576-8219
Provider Business Practice Location Address Fax Number:
717-658-0652
Provider Enumeration Date:
05/04/2006