Provider First Line Business Practice Location Address:
36 HANOVER STREET
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
CODORUS
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
17311-0128
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
717-229-2972
Provider Business Practice Location Address Fax Number:
717-229-0542
Provider Enumeration Date:
06/08/2006