Provider First Line Business Practice Location Address:
146 RECREATIONAL BUILDING
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
STATE COLLEGE
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
16801-4247
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
484-753-1724
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
01/30/2021