Provider First Line Business Practice Location Address:
231 NORTH SHIPPEN PLACE
Provider Second Line Business Practice Location Address:
SUITE 3D
Provider Business Practice Location Address City Name:
LANCASTER
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
17602
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
717-392-3211
Provider Business Practice Location Address Fax Number:
717-392-5506
Provider Enumeration Date:
08/10/2006