Provider First Line Business Practice Location Address:
221 WEST PENN AVENUE
Provider Second Line Business Practice Location Address:
SUITE 213
Provider Business Practice Location Address City Name:
CLEONA
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
17042
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
717-272-8500
Provider Business Practice Location Address Fax Number:
717-272-6101
Provider Enumeration Date:
08/14/2006