Provider First Line Business Practice Location Address:
1913 CALEDONIA ST
Provider Second Line Business Practice Location Address:
SUITE 2B
Provider Business Practice Location Address City Name:
HARRISBURG
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
17104-2932
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
717-657-7626
Provider Business Practice Location Address Fax Number:
717-657-1918
Provider Enumeration Date:
06/13/2013