Provider First Line Business Practice Location Address:
302 W MAIN ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
EMMITSBURG
Provider Business Practice Location Address State Name:
MD
Provider Business Practice Location Address Postal Code:
21727-9192
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
301-447-3369
Provider Business Practice Location Address Fax Number:
301-447-2485
Provider Enumeration Date:
05/31/2006