Provider First Line Business Practice Location Address:
2336 FRUITVILLE PIKE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
LANCASTER
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
17601-3257
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
717-682-8215
Provider Business Practice Location Address Fax Number:
888-977-1063
Provider Enumeration Date:
11/12/2010