Provider First Line Business Practice Location Address:
4655 LINGLESTOWN 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:
17112-8555
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
717-652-4551
Provider Business Practice Location Address Fax Number:
717-652-7305
Provider Enumeration Date:
10/26/2007