Provider First Line Business Practice Location Address:
251 VERBEKE 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:
17102-2739
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
814-876-2938
Provider Business Practice Location Address Fax Number:
410-569-0094
Provider Enumeration Date:
03/19/2014