Provider First Line Business Practice Location Address: 
425 FRANKLIN FARM LN
    Provider Second Line Business Practice Location Address: 
HUMAN SERVICE BUILDING
    Provider Business Practice Location Address City Name: 
CHAMBERSBURG
    Provider Business Practice Location Address State Name: 
PA
    Provider Business Practice Location Address Postal Code: 
17201-3064
    Provider Business Practice Location Address Country Code: 
US
    Provider Business Practice Location Address Telephone Number: 
717-264-5387
    Provider Business Practice Location Address Fax Number: 
717-264-6297
    Provider Enumeration Date: 
01/25/2006