Provider First Line Business Practice Location Address:
1460 MEMORY LANE EXT
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:
17402-9602
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
717-757-5433
Provider Business Practice Location Address Fax Number:
717-751-0392
Provider Enumeration Date:
08/21/2009