Provider First Line Business Practice Location Address:
2323 LINGLESTOWN 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:
17110-9424
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
717-516-6405
Provider Business Practice Location Address Fax Number:
717-857-7157
Provider Enumeration Date:
11/22/2017