Provider First Line Business Practice Location Address:
712 GLENDALE RD
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:
17403-4128
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
717-495-9688
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
10/28/2008