Provider First Line Business Practice Location Address:
924 COLONIAL AVE
Provider Second Line Business Practice Location Address:
BLDG 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
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
717-843-9089
Provider Business Practice Location Address Fax Number:
717-843-6075
Provider Enumeration Date:
01/10/2006