Provider First Line Business Practice Location Address:
1560 LITITZ PIKE
Provider Second Line Business Practice Location Address:
SUITE 1
Provider Business Practice Location Address City Name:
LANCASTER
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
17601-6523
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
717-490-6122
Provider Business Practice Location Address Fax Number:
717-490-6167
Provider Enumeration Date:
02/17/2011