Provider First Line Business Practice Location Address:
2501 NORTH THIRD STREET
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:
17110-2310
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
717-782-4783
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
05/19/2009