Provider First Line Business Practice Location Address: 
1001 S GEORGE ST
    Provider Second Line Business Practice Location Address: 
    Provider Business Practice Location Address City Name: 
YORK
    Provider Business Practice Location Address State Name: 
PA
    Provider Business Practice Location Address Postal Code: 
17403-3676
    Provider Business Practice Location Address Country Code: 
US
    Provider Business Practice Location Address Telephone Number: 
717-812-4602
    Provider Business Practice Location Address Fax Number: 
717-812-3499
    Provider Enumeration Date: 
06/01/2022