Provider First Line Business Practice Location Address:
2709 SOUTH QUEEN STREET
Provider Second Line Business Practice Location Address:
UNIT #1
Provider Business Practice Location Address City Name:
YORK
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
17403
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
717-741-1128
Provider Business Practice Location Address Fax Number:
717-741-2131
Provider Enumeration Date:
11/09/2006