Provider First Line Business Practice Location Address:
1100 S CAMERON 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:
17104-2547
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
717-238-7662
Provider Business Practice Location Address Fax Number:
717-238-7894
Provider Enumeration Date:
09/27/2012