Provider First Line Business Practice Location Address:
100 N CAMERON ST
Provider Second Line Business Practice Location Address:
SUITE 401 WEST, 4TH FLOOR
Provider Business Practice Location Address City Name:
HARRISBURG
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
17101-2424
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
717-232-2946
Provider Business Practice Location Address Fax Number:
717-232-3519
Provider Enumeration Date:
06/28/2011