Provider First Line Business Practice Location Address:
160 ROOSEVELT AVE
Provider Second Line Business Practice Location Address:
SUITE 102
Provider Business Practice Location Address City Name:
YORK
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
17401-3378
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
717-812-3020
Provider Business Practice Location Address Fax Number:
717-848-2658
Provider Enumeration Date:
01/17/2007