Provider First Line Business Practice Location Address:
1126 KENNEBEC DR
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
CHAMBERSBURG
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
17201-2809
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
717-658-4003
Provider Business Practice Location Address Fax Number:
717-263-2655
Provider Enumeration Date:
02/25/2014