Provider First Line Business Practice Location Address:
2104 HARRISBURG PIKE
Provider Second Line Business Practice Location Address:
SUITE 100
Provider Business Practice Location Address City Name:
LANCASTER
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
17601-2644
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
717-544-3684
Provider Business Practice Location Address Fax Number:
717-544-3597
Provider Enumeration Date:
11/05/2010