Provider First Line Business Practice Location Address:
1399 S QUEEN ST
Provider Second Line Business Practice Location Address:
LOWER LEVEL
Provider Business Practice Location Address City Name:
YORK
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
17403-3840
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
717-812-2921
Provider Business Practice Location Address Fax Number:
717-812-2921
Provider Enumeration Date:
08/23/2005