Provider First Line Business Practice Location Address:
2501 N 3RD ST FL 3
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:
17110-1904
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
717-782-4785
Provider Business Practice Location Address Fax Number:
717-782-6471
Provider Enumeration Date:
08/24/2007