Provider First Line Business Practice Location Address:
1700 FRUITVILLE PIKE STE A
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:
17601-4098
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
717-397-8161
Provider Business Practice Location Address Fax Number:
717-397-8192
Provider Enumeration Date:
07/11/2006