Provider First Line Business Practice Location Address:
907 ROOSEVELT AVE
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:
17404-2892
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
717-424-6683
Provider Business Practice Location Address Fax Number:
717-779-0188
Provider Enumeration Date:
02/15/2007