Provider First Line Business Practice Location Address:
3227 BATESFIELD 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:
17109-1902
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
717-657-8372
Provider Business Practice Location Address Fax Number:
717-657-8372
Provider Enumeration Date:
07/12/2006