Provider First Line Business Practice Location Address:
2112 HARRISBURG PIKE
Provider Second Line Business Practice Location Address:
SUITE 323
Provider Business Practice Location Address City Name:
LANCASTER
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
17601-2644
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
717-544-3569
Provider Business Practice Location Address Fax Number:
717-544-3570
Provider Enumeration Date:
11/22/2005