Provider First Line Business Practice Location Address:
133 E FREDERICK ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
LANCASTER
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
17602-2222
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
717-394-9821
Provider Business Practice Location Address Fax Number:
717-394-0175
Provider Enumeration Date:
09/20/2005