Provider First Line Business Practice Location Address:
6310 ALLENTOWN BLVD STE 105
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:
17112-2739
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
717-982-4488
Provider Business Practice Location Address Fax Number:
717-370-5934
Provider Enumeration Date:
09/18/2023