Provider First Line Business Practice Location Address:
7311 GREEN HILL 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:
17111-4919
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
717-503-2885
Provider Business Practice Location Address Fax Number:
717-489-1762
Provider Enumeration Date:
12/29/2010