Provider First Line Business Practice Location Address:
4343 UNION DEPOSIT RD
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:
17111-2907
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
717-564-5690
Provider Business Practice Location Address Fax Number:
717-564-8490
Provider Enumeration Date:
09/12/2006