Provider First Line Business Practice Location Address:
7955 JONESTOWN 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:
17112-9728
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
717-545-0004
Provider Business Practice Location Address Fax Number:
717-545-8998
Provider Enumeration Date:
01/14/2009