Provider First Line Business Practice Location Address:
228 N 14TH ST
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:
17103-1305
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
717-317-8713
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
02/05/2016