Provider First Line Business Practice Location Address:
2106 HARRISBURG PIKE
Provider Second Line Business Practice Location Address:
SUITE 1
Provider Business Practice Location Address City Name:
LANCASTER
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
17601-2644
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
717-291-5931
Provider Business Practice Location Address Fax Number:
717-735-9119
Provider Enumeration Date:
05/25/2011