Provider First Line Business Practice Location Address:
924 COLONIAL AVE STE M
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
YORK
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
17403-3450
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
717-845-4846
Provider Business Practice Location Address Fax Number:
717-845-5181
Provider Enumeration Date:
08/01/2005