Provider First Line Business Practice Location Address:
1834 OREGON PIKE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
LANCASTER
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
17601-6463
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
717-569-6461
Provider Business Practice Location Address Fax Number:
717-569-5793
Provider Enumeration Date:
11/01/2006