Provider First Line Business Practice Location Address:
39 W VINE 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:
17603-3946
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
717-394-5496
Provider Business Practice Location Address Fax Number:
717-533-6071
Provider Enumeration Date:
10/26/2007