Provider First Line Business Practice Location Address:
960 LANCASTER AVE
Provider Second Line Business Practice Location Address:
COLUMBIA PLAZA
Provider Business Practice Location Address City Name:
COLUMBIA
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
17512-1857
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
717-684-5808
Provider Business Practice Location Address Fax Number:
717-684-5126
Provider Enumeration Date:
12/11/2006