Provider First Line Business Practice Location Address:
207 HOUSE AVE
Provider Second Line Business Practice Location Address:
SUITE 107 - ROOM 1
Provider Business Practice Location Address City Name:
CAMP HILL
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
17011-2308
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
717-731-1900
Provider Business Practice Location Address Fax Number:
717-567-0308
Provider Enumeration Date:
01/11/2016