Provider First Line Business Practice Location Address:
38 BLACK AVENUE
Provider Second Line Business Practice Location Address:
SUITE 1
Provider Business Practice Location Address City Name:
CHAMBERSBURG
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
17201-2115
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
717-387-2751
Provider Business Practice Location Address Fax Number:
717-264-0045
Provider Enumeration Date:
07/19/2010