Provider First Line Business Practice Location Address:
219 W SCHOOL DR
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
LINESVILLE
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
16424-8609
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
814-683-5900
Provider Business Practice Location Address Fax Number:
814-683-4127
Provider Enumeration Date:
04/27/2006