Provider First Line Business Practice Location Address:
911 LOGAN BLVD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
ALTOONA
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
16602-4025
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
814-946-4000
Provider Business Practice Location Address Fax Number:
814-946-4777
Provider Enumeration Date:
08/26/2010