Provider First Line Business Practice Location Address:
38 BLACK AVE
Provider Second Line Business Practice Location Address:
SUITE 2
Provider Business Practice Location Address City Name:
CHAMBERSBURG
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
17201-2115
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
717-496-8521
Provider Business Practice Location Address Fax Number:
717-307-3487
Provider Enumeration Date:
09/27/2006