Provider First Line Business Practice Location Address:
712 S LOGAN BLVD
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:
16648-3032
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
814-946-1950
Provider Business Practice Location Address Fax Number:
814-946-5725
Provider Enumeration Date:
03/23/2007