Provider First Line Business Practice Location Address:
RT 22 CROOKED CREEK ROAD
Provider Second Line Business Practice Location Address:
BOX 250 SUITE 2
Provider Business Practice Location Address City Name:
HUNTINGDON
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
16652
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
717-242-2721
Provider Business Practice Location Address Fax Number:
717-242-3510
Provider Enumeration Date:
01/04/2007