Provider First Line Business Practice Location Address:
1497A S. QUEEN STREET
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:
17403
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
717-848-3979
Provider Business Practice Location Address Fax Number:
717-668-8967
Provider Enumeration Date:
09/07/2005