| LCA CASE NUMBER | I-200-20224-762001 |
| STATUS | Certified |
| LCA CASE SUBMIT | 2020-08-11 |
| DECISION DATE | 2020-08-18 |
| VISA CLASS | H-1B |
| LCA CASE JOB TITLE | Dentist |
| SOC CODE | 29-1021.00 |
| SOC TITLE | Dentists, General |
| FULL TIME POSITION | Y |
| LCA CASE EMPLOYMENT START DATE | 2020-09-01 |
| END DATE | 2023-08-31 |
| TOTAL WORKER POSITIONS | 1 |
| NEW EMPLOYMENT | 0 |
| CONTINUED EMPLOYMENT | 0 |
| CHANGE PREVIOUS EMPLOYMENT | 0 |
| NEW CONCURRENT EMPLOYMENT | 0 |
| CHANGE EMPLOYER | 1 |
| AMENDED PETITION | 0 |
| LCA CASE EMPLOYER NAME | KEYSTONE RURAL HEALTH CENTER |
| EMPLOYER ADDRESS1 | 111 Chambers Hill Drive |
| EMPLOYER ADDRESS2 | STE 200 |
| EMPLOYER CITY | CHAMBERSBURG |
| EMPLOYER STATE | PA |
| EMPLOYER POSTAL CODE | 17201 |
| EMPLOYER COUNTRY | UNITED STATES OF AMERICA |
| EMPLOYER PROVINCE | PENNSYLVANIA |
| EMPLOYER PHONE | 17177097900 |
| NAICS CODE | 62111 |
| EMPLOYER POC LAST NAME | Ehrhart |
| EMPLOYER POC FIRST NAME | Amy |
| EMPLOYER POC JOB TITLE | HR Generalist/Safety Manager |
| EMPLOYER POC ADDRESS1 | 111 Chambers Hill Drive |
| EMPLOYER POC ADDRESS2 | Ste 200 |
| EMPLOYER POC CITY | Chambersburg |
| EMPLOYER POC STATE | PA |
| EMPLOYER POC POSTAL CODE | 17201 |
| EMPLOYER POC COUNTRY | UNITED STATES OF AMERICA |
| EMPLOYER POC PHONE | 17177097900 |
| EMPLOYER POC EMAIL | aehrhart@keystonehealth.org |
| AGENT REPRESENTING EMPLOYER | Y |
| AGENT ATTORNEY LAST NAME | Kelly |
| AGENT ATTORNEY FIRST NAME | Dayna |
| AGENT ATTORNEY MIDDLE NAME | Jo |
| AGENT ATTORNEY ADDRESS1 | 250 E. Winmore Ave |
| AGENT ATTORNEY CITY | Chapel Hill |
| AGENT ATTORNEY STATE | NC |
| AGENT ATTORNEY POSTAL CODE | 27516 |
| AGENT ATTORNEY COUNTRY | UNITED STATES OF AMERICA |
| AGENT ATTORNEY PHONE | 19199697200.0 |
| AGENT ATTORNEY EMAIL ADDRESS | INFO@DKELLY.COM |
|
| LAWFIRM NAME BUSINESS NAME | Law Offices of Dayna Kelly, PC |
| STATE OF HIGHEST COURT | NC |
| NAME OF HIGHEST STATE COURT | Supreme Court |
| WORKSITE WORKERS | 1 |
| SECONDARY ENTITY | N |
| WORKSITE ADDRESS1 | 767 Fifth Ave |
| LCA CASE WORKLOC1 CITY | Chambersburg |
| WORKSITE COUNTY | FRANKLIN |
| LCA CASE WORKLOC1 STATE | PA |
| WORKSITE POSTAL CODE | 17201 |
| LCA CASE WAGE RATE FROM | 125000.0 |
| LCA CASE WAGE RATE TO | 175000.0 |
| LCA CASE WAGE RATE UNIT | Year |
| PREVAILING WAGE | 92102.0 |
| PW UNIT OF PAY | Year |
| PW WAGE LEVEL | I |
| PW OES YEAR | 7/1/2020 - 6/30/2021 |
| TOTAL WORKSITE LOCATIONS | 2 |
| AGREE TO LC STATEMENT | Y |
| H-1B DEPENDENT | N |
| WILLFUL VIOLATOR | N |
| PUBLIC DISCLOSURE | Disclose Business |
