Provider First Line Business Practice Location Address:
4601 DEVONSHIRE RD
Provider Second Line Business Practice Location Address:
SUITE 100
Provider Business Practice Location Address City Name:
HARRISBURG
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
17109-1547
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
717-764-8737
Provider Business Practice Location Address Fax Number:
717-764-3577
Provider Enumeration Date:
07/24/2007