Provider First Line Business Practice Location Address:
3620 OLD TRAIL RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
YORK HAVEN
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
17370-9734
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
717-932-4831
Provider Business Practice Location Address Fax Number:
717-932-4830
Provider Enumeration Date:
05/04/2009