Provider First Line Business Practice Location Address:
1801 FRUITVILLE PIKE
Provider Second Line Business Practice Location Address:
SUITE 201
Provider Business Practice Location Address City Name:
LANCASTER
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
17601-4079
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
717-556-4673
Provider Business Practice Location Address Fax Number:
717-656-4501
Provider Enumeration Date:
08/29/2011