Provider First Line Business Practice Location Address:
2405 LINGLESTOWN RD
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:
17110-9429
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
717-657-8564
Provider Business Practice Location Address Fax Number:
717-657-2601
Provider Enumeration Date:
01/18/2006