Provider First Line Business Practice Location Address:
757 NORLAND AVENUE
Provider Second Line Business Practice Location Address:
SUITE 203
Provider Business Practice Location Address City Name:
CHAMBERSBURG
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
17201-4231
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
717-217-6870
Provider Business Practice Location Address Fax Number:
717-217-6945
Provider Enumeration Date:
06/16/2005