Provider First Line Business Practice Location Address:
4811 JONESTOWN RD
Provider Second Line Business Practice Location Address:
SUITE 228
Provider Business Practice Location Address City Name:
HARRISBURG
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
17109-1745
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
717-545-4853
Provider Business Practice Location Address Fax Number:
717-545-0541
Provider Enumeration Date:
11/08/2013