Provider First Line Business Practice Location Address:
210 S PRINCE ST
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:
17603-5314
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
717-367-9115
Provider Business Practice Location Address Fax Number:
717-367-9759
Provider Enumeration Date:
06/15/2012