Provider First Line Business Practice Location Address:
176 S. COLDBROOK AVENUE
Provider Second Line Business Practice Location Address:
UNIT 2
Provider Business Practice Location Address City Name:
CHAMBERSBURG
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
17211-2714
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
717-267-7480
Provider Business Practice Location Address Fax Number:
717-267-7403
Provider Enumeration Date:
06/27/2007