Provider First Line Business Practice Location Address:
1575 BANNISTER ST
Provider Second Line Business Practice Location Address:
SUITE 7
Provider Business Practice Location Address City Name:
YORK
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
17404-4946
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
717-851-6454
Provider Business Practice Location Address Fax Number:
717-851-1665
Provider Enumeration Date:
12/19/2006