Provider First Line Business Practice Location Address:
1617 N FRONT ST
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:
17102-2414
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
717-236-4682
Provider Business Practice Location Address Fax Number:
717-236-2423
Provider Enumeration Date:
01/24/2019