Provider First Line Business Practice Location Address:
251 N PROGRESS AVE
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:
17109-1927
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
717-695-9258
Provider Business Practice Location Address Fax Number:
717-525-9257
Provider Enumeration Date:
01/20/2012