Provider First Line Business Practice Location Address:
230 HARRISBURG AVE
Provider Second Line Business Practice Location Address:
SUITE 8
Provider Business Practice Location Address City Name:
LANCASTER
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
17603-2959
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
717-509-1931
Provider Business Practice Location Address Fax Number:
717-509-1934
Provider Enumeration Date:
10/09/2006