Provider First Line Business Practice Location Address:
200 SHORT ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
PHILIPSBURG
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
16866-2640
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
814-342-1050
Provider Business Practice Location Address Fax Number:
814-342-7208
Provider Enumeration Date:
05/27/2006