Provider First Line Business Practice Location Address:
315 S ALLEN ST STE 323
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
STATE COLLEGE
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
16801-4851
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
814-237-7123
Provider Business Practice Location Address Fax Number:
814-692-0018
Provider Enumeration Date:
05/19/2010