Provider First Line Business Practice Location Address:
316 N MAIN ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
DAVIDSVILLE
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
15928-9500
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
814-479-4525
Provider Business Practice Location Address Fax Number:
814-479-2615
Provider Enumeration Date:
05/14/2007