Provider First Line Business Practice Location Address:
818 WABANK ST
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:
17603-5741
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
717-725-3914
Provider Business Practice Location Address Fax Number:
717-256-7840
Provider Enumeration Date:
07/27/2012