Provider First Line Business Practice Location Address:
2109 US HIGHWAY 522 S
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
MC VEYTOWN
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
17051-9429
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
814-542-8630
Provider Business Practice Location Address Fax Number:
814-542-4970
Provider Enumeration Date:
02/06/2007