Provider First Line Business Practice Location Address:
1475 BANNISTER STREET
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
YORK
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
17404
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
717-846-5653
Provider Business Practice Location Address Fax Number:
717-699-4433
Provider Enumeration Date:
10/02/2006