Provider First Line Business Practice Location Address:
5775 ALLENTOWN BLVD
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:
17112-4049
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
717-657-1629
Provider Business Practice Location Address Fax Number:
717-657-3241
Provider Enumeration Date:
11/01/2006