Provider First Line Business Practice Location Address:
620 HOWARD AVE.
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:
16601-4899
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
814-946-2223
Provider Business Practice Location Address Fax Number:
814-946-7808
Provider Enumeration Date:
01/03/2007