Provider First Line Business Practice Location Address:
2019 N 2ND ST
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:
17102-2147
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
717-221-8004
Provider Business Practice Location Address Fax Number:
717-221-8006
Provider Enumeration Date:
12/18/2015