Provider First Line Business Practice Location Address:
1320 LINGLESTOWN ROAD
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:
17110-2822
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
717-732-1000
Provider Business Practice Location Address Fax Number:
717-234-0416
Provider Enumeration Date:
05/17/2016