Provider First Line Business Practice Location Address:
18741 STATE HWY 198
Provider Second Line Business Practice Location Address:
SUITE 101
Provider Business Practice Location Address City Name:
SAEGERTOWN
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
16433-4315
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
814-337-1626
Provider Business Practice Location Address Fax Number:
814-763-5129
Provider Enumeration Date:
05/27/2006