Provider First Line Business Practice Location Address:
49 PRINCE 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:
17109-3113
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
717-901-3440
Provider Business Practice Location Address Fax Number:
717-901-3447
Provider Enumeration Date:
07/24/2009