Provider First Line Business Practice Location Address:
1201 MEMORY LANE EXT STE A
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:
17402-9608
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
717-305-1757
Provider Business Practice Location Address Fax Number:
717-204-5568
Provider Enumeration Date:
09/22/2022