Provider First Line Business Practice Location Address:
247 N SHIPPEN ST
Provider Second Line Business Practice Location Address:
STE110
Provider Business Practice Location Address City Name:
LANCASTER
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
17602-2769
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
717-517-8195
Provider Business Practice Location Address Fax Number:
717-517-8219
Provider Enumeration Date:
03/05/2014