Provider First Line Business Practice Location Address:
2644 N 6TH 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:
17110-2604
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
205-937-7049
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
03/22/2025