Provider First Line Business Practice Location Address:
121 W ALLEGHENY ST
Provider Second Line Business Practice Location Address:
KOPP DRUG INC
Provider Business Practice Location Address City Name:
MARTINSBURG
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
16662-1103
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
814-793-2171
Provider Business Practice Location Address Fax Number:
814-793-9777
Provider Enumeration Date:
08/03/2005