Provider First Line Business Practice Location Address:
142 EAST CARROLL STREET
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
CARROLLTOWN
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
15722-0597
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
814-344-9238
Provider Business Practice Location Address Fax Number:
814-344-8760
Provider Enumeration Date:
11/30/2010