Provider First Line Business Practice Location Address:
451 LATIMORE CREEK RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
YORK SPRINGS
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
17372-9036
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
610-216-7918
Provider Business Practice Location Address Fax Number:
773-815-8605
Provider Enumeration Date:
01/14/2013