Provider First Line Business Practice Location Address:
4513 JONESTOWN RD
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:
17109-6213
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
717-909-6020
Provider Business Practice Location Address Fax Number:
717-909-4037
Provider Enumeration Date:
08/08/2006