Provider First Line Business Practice Location Address:
450 POWERS AVE
Provider Second Line Business Practice Location Address:
LOWER LEVEL
Provider Business Practice Location Address City Name:
HARRISBURG
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
17109-5933
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
717-920-4950
Provider Business Practice Location Address Fax Number:
717-920-4955
Provider Enumeration Date:
09/21/2005