Provider First Line Business Practice Location Address:
140 ROOSEVELT AVE STE 208
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:
17401-3333
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
717-843-7845
Provider Business Practice Location Address Fax Number:
855-893-0655
Provider Enumeration Date:
11/16/2007