Provider First Line Business Practice Location Address:
447 S PRINCE ST
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:
17603-5657
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
717-823-9818
Provider Business Practice Location Address Fax Number:
717-798-9911
Provider Enumeration Date:
10/30/2007