Provider First Line Business Practice Location Address:
5955 LINGLESTOWN RD STE D
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:
17112-1125
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
717-352-5104
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
03/26/2026