Provider First Line Business Practice Location Address:
69 ST. PAUL DRIVE
Provider Second Line Business Practice Location Address:
SUITE A
Provider Business Practice Location Address City Name:
CHAMBERSBURG
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
17201-4231
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
717-217-6789
Provider Business Practice Location Address Fax Number:
717-496-8073
Provider Enumeration Date:
08/22/2005