Provider First Line Business Practice Location Address:
617A NORTH PRINCE STREET
Provider Second Line Business Practice Location Address:
SUITE L
Provider Business Practice Location Address City Name:
LANCASTER
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
17603
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
717-390-4288
Provider Business Practice Location Address Fax Number:
717-390-4825
Provider Enumeration Date:
06/24/2009