Provider First Line Business Practice Location Address:
591 N 67TH 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:
17111-4502
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
717-564-2439
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
08/04/2006