Provider First Line Business Practice Location Address:
230 S POTOMAC ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
WAYNESBORO
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
17268-2642
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
717-762-0879
Provider Business Practice Location Address Fax Number:
717-762-4772
Provider Enumeration Date:
07/28/2005