Provider First Line Business Practice Location Address:
1313 MONROE ST
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:
17103-1139
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
717-703-1490
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
10/09/2007