Provider First Line Business Practice Location Address:
2899 WHITE FORD RD.
Provider Second Line Business Practice Location Address:
YORK GALLERIA MALL SPACE 140
Provider Business Practice Location Address City Name:
YORK
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
17402
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
717-600-0586
Provider Business Practice Location Address Fax Number:
717-840-7999
Provider Enumeration Date:
02/23/2007