Provider First Line Business Practice Location Address:
2550 KINGSTON RD
Provider Second Line Business Practice Location Address:
SUITE 106
Provider Business Practice Location Address City Name:
YORK
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
17402-3732
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
717-757-7148
Provider Business Practice Location Address Fax Number:
717-757-7246
Provider Enumeration Date:
06/10/2010