Provider First Line Business Practice Location Address:
2108 HARRISBURG PIKE
Provider Second Line Business Practice Location Address:
SUITE 314
Provider Business Practice Location Address City Name:
LANCASTER
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
17601
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
717-544-3154
Provider Business Practice Location Address Fax Number:
717-544-3166
Provider Enumeration Date:
09/29/2005