Provider First Line Business Practice Location Address:
2600 PLANK RD. COMMONS
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
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
814-949-8991
Provider Business Practice Location Address Fax Number:
814-949-8993
Provider Enumeration Date:
10/27/2006