Provider First Line Business Practice Location Address:
6475 CARLISLE PIKE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
MECHANICSBURG
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
17050-2385
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
717-766-7693
Provider Business Practice Location Address Fax Number:
717-795-1740
Provider Enumeration Date:
05/23/2005