Provider First Line Business Practice Location Address:
1800 STATE 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:
17103-1551
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
717-221-0722
Provider Business Practice Location Address Fax Number:
717-221-0843
Provider Enumeration Date:
08/22/2007