Provider First Line Business Practice Location Address:
320 BLAIR ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
HOLLIDAYSBURG
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
16648-1804
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
814-696-3354
Provider Business Practice Location Address Fax Number:
814-696-0560
Provider Enumeration Date:
06/22/2006