Provider First Line Business Practice Location Address:
4940 LINGLESTOWN RD
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:
17112-9515
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
717-901-7045
Provider Business Practice Location Address Fax Number:
717-901-7050
Provider Enumeration Date:
02/28/2007