Provider First Line Business Practice Location Address:
7841 PAXTON 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:
17111-5426
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
717-558-8110
Provider Business Practice Location Address Fax Number:
717-558-8115
Provider Enumeration Date:
02/05/2014