Provider First Line Business Practice Location Address:
984 LOUCKS RD STE I
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:
17404-2274
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
717-845-8599
Provider Business Practice Location Address Fax Number:
717-845-9256
Provider Enumeration Date:
06/08/2006