Provider First Line Business Practice Location Address:
1820 LINGLESTOWN RD
Provider Second Line Business Practice Location Address:
SUITE SE-L
Provider Business Practice Location Address City Name:
HARRISBURG
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
17110-3339
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
717-901-5099
Provider Business Practice Location Address Fax Number:
717-901-0388
Provider Enumeration Date:
04/12/2013