Provider First Line Business Practice Location Address:
1600 6TH AVE
Provider Second Line Business Practice Location Address:
SUITE 108
Provider Business Practice Location Address City Name:
YORK
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
17403-2626
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
717-815-2562
Provider Business Practice Location Address Fax Number:
717-815-2563
Provider Enumeration Date:
07/26/2010