Provider First Line Business Practice Location Address:
480 NEW HOLLAND AVE
Provider Second Line Business Practice Location Address:
BUILDING 8, SUITE 8101
Provider Business Practice Location Address City Name:
LANCASTER
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
17602-2291
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
717-291-8396
Provider Business Practice Location Address Fax Number:
717-291-6788
Provider Enumeration Date:
06/21/2007