Provider First Line Business Practice Location Address:
700 S POTOMAC ST
Provider Second Line Business Practice Location Address:
SUITE 1
Provider Business Practice Location Address City Name:
WAYNESBORO
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
17268-2198
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
717-762-1773
Provider Business Practice Location Address Fax Number:
717-762-8544
Provider Enumeration Date:
01/24/2006