Provider First Line Business Practice Location Address:
10 CAPITAL DRIVE
Provider Second Line Business Practice Location Address:
SUITE 100
Provider Business Practice Location Address City Name:
HARRISBURG
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
17110
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
717-728-1700
Provider Business Practice Location Address Fax Number:
717-728-1701
Provider Enumeration Date:
09/21/2005