Provider First Line Business Practice Location Address:
2818 GREEN STREET
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:
17110-1228
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
717-238-6880
Provider Business Practice Location Address Fax Number:
717-238-6885
Provider Enumeration Date:
02/07/2007