Provider First Line Business Practice Location Address:
2 WATERFORD PROFESSIONAL CTR STE 6C
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
YORK
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
17402-9300
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
717-870-6563
Provider Business Practice Location Address Fax Number:
717-755-2322
Provider Enumeration Date:
03/23/2006