Provider First Line Business Practice Location Address:
2225 KOHN 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:
17110-9604
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
443-987-2156
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
08/02/2011