Provider First Line Business Practice Location Address:
503 N FRONT ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
PHILIPSBURG
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
16866-2125
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
814-342-4844
Provider Business Practice Location Address Fax Number:
814-342-4866
Provider Enumeration Date:
05/03/2006