Provider First Line Business Practice Location Address:
915 N MOUNTAIN RD
Provider Second Line Business Practice Location Address:
SUITE C
Provider Business Practice Location Address City Name:
HARRISBURG
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
17112-1793
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
717-652-5550
Provider Business Practice Location Address Fax Number:
717-652-2488
Provider Enumeration Date:
03/26/2014