Provider First Line Business Practice Location Address:
1805 LOUCKS RD
Provider Second Line Business Practice Location Address:
SUITE 200
Provider Business Practice Location Address City Name:
YORK
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
17408-7902
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
717-764-0144
Provider Business Practice Location Address Fax Number:
717-764-0554
Provider Enumeration Date:
06/10/2014