Provider First Line Business Practice Location Address:
21 S RIVER 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:
17101-2017
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
717-236-9401
Provider Business Practice Location Address Fax Number:
717-236-3821
Provider Enumeration Date:
06/01/2016