Provider First Line Business Practice Location Address:
90 EAST 2ND ST. P.O. BOX 270
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
EMPORIUM
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
15834
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
814-486-1115
Provider Business Practice Location Address Fax Number:
814-486-0404
Provider Enumeration Date:
10/19/2026