Provider First Line Business Practice Location Address:
41 S FRANKLIN ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
DU BOIS
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
15801-1801
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
814-375-5250
Provider Business Practice Location Address Fax Number:
814-375-5524
Provider Enumeration Date:
11/07/2008