Provider First Line Business Practice Location Address:
4701 DUKE ST
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:
17109-3041
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
717-657-3441
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
07/19/2006