Provider First Line Business Practice Location Address:
900 S ARLINGTON AVE RM 242A
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:
17109-5027
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
717-695-0256
Provider Business Practice Location Address Fax Number:
717-740-2929
Provider Enumeration Date:
05/24/2018