Provider First Line Business Practice Location Address:
1555 N QUEEN ST
Provider Second Line Business Practice Location Address:
SUITE 1A
Provider Business Practice Location Address City Name:
YORK
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
17404-2129
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
717-848-2273
Provider Business Practice Location Address Fax Number:
717-848-2272
Provider Enumeration Date:
02/17/2016