Provider First Line Business Practice Location Address:
1005 PENN ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
HOLLIDAYSBURG
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
16648
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
814-695-4456
Provider Business Practice Location Address Fax Number:
814-695-1694
Provider Enumeration Date:
07/25/2006