Provider First Line Business Practice Location Address:
775 S ARLINGTON AVE
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:
17109-5002
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
717-541-9240
Provider Business Practice Location Address Fax Number:
717-541-9243
Provider Enumeration Date:
09/12/2005