Provider First Line Business Practice Location Address:
4807 JONESTOWN RD
Provider Second Line Business Practice Location Address:
SUITE 141
Provider Business Practice Location Address City Name:
HARRISBURG
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
17109-1739
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
717-657-3030
Provider Business Practice Location Address Fax Number:
717-671-0991
Provider Enumeration Date:
11/13/2008