Provider First Line Business Practice Location Address:
1 KENNEDY 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:
17602-4098
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
717-517-9087
Provider Business Practice Location Address Fax Number:
717-517-9322
Provider Enumeration Date:
10/15/2013