Provider First Line Business Practice Location Address:
1051 EAST MAIN STREET
Provider Second Line Business Practice Location Address:
SUITE 5
Provider Business Practice Location Address City Name:
WAYNESBORO
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
17268
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
717-762-9981
Provider Business Practice Location Address Fax Number:
717-762-9983
Provider Enumeration Date:
06/28/2005