Provider First Line Business Practice Location Address:
1101 S EDGAR ST
Provider Second Line Business Practice Location Address:
SUITE E
Provider Business Practice Location Address City Name:
YORK
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
17403-2862
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
717-851-1566
Provider Business Practice Location Address Fax Number:
717-851-1569
Provider Enumeration Date:
07/24/2006