Provider First Line Business Practice Location Address:
3560 N PROGRESS AVE
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:
17110-9657
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
717-671-4700
Provider Business Practice Location Address Fax Number:
717-671-4598
Provider Enumeration Date:
05/14/2008