Provider First Line Business Practice Location Address:
12 ST PAUL 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:
17201-1035
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
717-217-6886
Provider Business Practice Location Address Fax Number:
717-217-6896
Provider Enumeration Date:
05/25/2009