Provider First Line Business Practice Location Address:
6007 ALLENTOWN BLVD
Provider Second Line Business Practice Location Address:
C/O CVS
Provider Business Practice Location Address City Name:
HARRISBURG
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
17112
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
717-540-5893
Provider Business Practice Location Address Fax Number:
717-540-5663
Provider Enumeration Date:
10/04/2007