Provider First Line Business Practice Location Address:
552 RACE 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:
17104-1646
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
717-254-7022
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
02/21/2008