Provider First Line Business Practice Location Address:
200 MIFFLIN ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
HUNTINGDON
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
16652-1436
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
814-641-4327
Provider Business Practice Location Address Fax Number:
814-641-7104
Provider Enumeration Date:
01/22/2008