Provider First Line Business Practice Location Address:
401 DIVISION 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:
17110-2058
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
717-782-4349
Provider Business Practice Location Address Fax Number:
717-782-6518
Provider Enumeration Date:
12/27/2016