Provider First Line Business Practice Location Address:
503 NORTH 21ST ST.
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
CAMP HILL
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
17011-8572
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
717-763-2196
Provider Business Practice Location Address Fax Number:
717-763-2947
Provider Enumeration Date:
04/04/2012