Provider First Line Business Practice Location Address:
426 PHOENIX 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:
17201-4537
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
717-261-9833
Provider Business Practice Location Address Fax Number:
717-261-9832
Provider Enumeration Date:
07/21/2010