Provider First Line Business Practice Location Address:
PENN STATE AT CLINIC
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:
16801-1680
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
610-780-9963
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
02/15/2021