Provider First Line Business Practice Location Address:
3301 N FRONT 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:
17110-1436
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
717-909-4030
Provider Business Practice Location Address Fax Number:
717-909-4031
Provider Enumeration Date:
05/02/2006