Provider First Line Business Practice Location Address:
2237 N 2ND ST
Provider Second Line Business Practice Location Address:
APT 3
Provider Business Practice Location Address City Name:
HARRISBURG
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
17110-1092
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
717-395-1205
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
08/16/2011