Provider First Line Business Practice Location Address:
1937A FRUITVILLE PIKE
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:
17601-3995
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
717-569-5544
Provider Business Practice Location Address Fax Number:
717-569-2243
Provider Enumeration Date:
12/19/2007