Provider First Line Business Practice Location Address:
101 WASHINGTON STREET
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:
17104-1612
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
717-221-6258
Provider Business Practice Location Address Fax Number:
717-221-6266
Provider Enumeration Date:
06/12/2006