Provider First Line Business Practice Location Address:
2 WATERFORD PROFESSIONAL CTR
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:
17402-9198
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
717-755-0114
Provider Business Practice Location Address Fax Number:
717-840-9524
Provider Enumeration Date:
11/12/2006