Provider First Line Business Practice Location Address:
121 N NYES 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:
17112-3247
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
717-214-6545
Provider Business Practice Location Address Fax Number:
717-531-0639
Provider Enumeration Date:
12/28/2007