Provider First Line Business Practice Location Address:
4349 LINGLESTOWN RD STE B
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:
17112-9196
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
717-813-3090
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
11/26/2018