Provider First Line Business Practice Location Address:
2198 WALNUT ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
CAMP HILL
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
17011-3855
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
717-737-4623
Provider Business Practice Location Address Fax Number:
717-737-2708
Provider Enumeration Date:
06/16/2005