Provider First Line Business Practice Location Address:
1300 LINGLESTOWN 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:
17110-2838
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
717-234-8840
Provider Business Practice Location Address Fax Number:
717-234-8860
Provider Enumeration Date:
09/12/2006