Provider First Line Business Practice Location Address:
1819 S MARKET ST
Provider Second Line Business Practice Location Address:
BLDG A
Provider Business Practice Location Address City Name:
MECHANICSBURG
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
17055-5609
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
717-691-9683
Provider Business Practice Location Address Fax Number:
717-691-9689
Provider Enumeration Date:
04/25/2016