Provider First Line Business Practice Location Address: 
2845 EASTERN BLVD
    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: 
17402-2909
    Provider Business Practice Location Address Country Code: 
US
    Provider Business Practice Location Address Telephone Number: 
717-840-6444
    Provider Business Practice Location Address Fax Number: 
    Provider Enumeration Date: 
07/07/2016