Provider First Line Business Practice Location Address:
4371 UNION DEPOSIT 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:
17111-2905
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
717-561-1660
Provider Business Practice Location Address Fax Number:
717-561-8314
Provider Enumeration Date:
05/06/2006