Provider First Line Business Practice Location Address: 
128 N GEORGE ST
    Provider Second Line Business Practice Location Address: 
    Provider Business Practice Location Address City Name: 
YORK
    Provider Business Practice Location Address State Name: 
PA
    Provider Business Practice Location Address Postal Code: 
17401-1117
    Provider Business Practice Location Address Country Code: 
US
    Provider Business Practice Location Address Telephone Number: 
717-848-6116
    Provider Business Practice Location Address Fax Number: 
717-852-7580
    Provider Enumeration Date: 
09/30/2008