Provider First Line Business Practice Location Address:
21 NORTH 4TH 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:
17101
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
717-233-3476
Provider Business Practice Location Address Fax Number:
717-796-2409
Provider Enumeration Date:
05/27/2006