Provider First Line Business Practice Location Address:
13161 FERGUSON VALLEY RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
YEAGERTOWN
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
17099-0414
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
717-248-7248
Provider Business Practice Location Address Fax Number:
717-248-7323
Provider Enumeration Date:
08/17/2007