Provider First Line Business Practice Location Address:
220 CUMBERLAND PKWY
Provider Second Line Business Practice Location Address:
SUITE 3
Provider Business Practice Location Address City Name:
MECHANICSBURG
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
17055-5683
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
717-766-5174
Provider Business Practice Location Address Fax Number:
717-766-5194
Provider Enumeration Date:
07/20/2006