Provider First Line Business Practice Location Address:
2159 WHITE ST.
Provider Second Line Business Practice Location Address:
STE 17
Provider Business Practice Location Address City Name:
YORK
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
17404-4950
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
717-332-4377
Provider Business Practice Location Address Fax Number:
717-840-1787
Provider Enumeration Date:
07/23/2007