Provider First Line Business Practice Location Address:
1516 N 2ND 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:
17102-2556
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
717-234-6715
Provider Business Practice Location Address Fax Number:
717-234-8514
Provider Enumeration Date:
08/16/2006