Provider First Line Business Practice Location Address:
225 MARKET ST
Provider Second Line Business Practice Location Address:
SUITE 502
Provider Business Practice Location Address City Name:
HARRISBURG
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
17101-2126
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
717-635-2140
Provider Business Practice Location Address Fax Number:
717-635-2575
Provider Enumeration Date:
05/20/2010