Provider First Line Business Practice Location Address:
1415 DETWILER DR
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:
17404-1111
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
717-968-5431
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
07/20/2005