Provider First Line Business Practice Location Address:
800 N 3RD STREET
Provider Second Line Business Practice Location Address:
SUITE 408-C
Provider Business Practice Location Address City Name:
HARRISBURG
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
17102
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
814-725-1217
Provider Business Practice Location Address Fax Number:
814-725-1218
Provider Enumeration Date:
11/14/2018