Provider First Line Business Practice Location Address:
451 HUSTON AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
KNOX
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
16232-5503
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
814-797-5921
Provider Business Practice Location Address Fax Number:
814-797-2382
Provider Enumeration Date:
05/17/2006