Provider First Line Business Practice Location Address:
400 E 2ND ST
Provider Second Line Business Practice Location Address:
DEPT. OF EXERCISE SCIENCE
Provider Business Practice Location Address City Name:
BLOOMSBURG
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
17815-1301
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
570-389-4356
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
06/27/2006