Provider First Line Business Practice Location Address:
1801 N 5TH STREET
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:
17102-1510
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
717-781-5882
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
10/03/2012