Provider First Line Business Practice Location Address:
OMHSAS, ADMINISTRATION BLDG 11
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:
17105-2675
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
717-772-7316
Provider Business Practice Location Address Fax Number:
717-772-7699
Provider Enumeration Date:
02/21/2007