Provider First Line Business Practice Location Address:
970 LOUCKS RD
Provider Second Line Business Practice Location Address:
SUITE UNIT D
Provider Business Practice Location Address City Name:
YORK
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
17404-2273
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
717-764-1008
Provider Business Practice Location Address Fax Number:
717-764-1017
Provider Enumeration Date:
04/07/2014