Provider First Line Business Practice Location Address:
131 W 5TH 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:
17268-1916
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
717-762-7719
Provider Business Practice Location Address Fax Number:
717-762-1652
Provider Enumeration Date:
09/20/2005