Provider First Line Business Practice Location Address:
2837 EARLYSTOWN ROAD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
CENTRE HALL
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
16828
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
814-364-9000
Provider Business Practice Location Address Fax Number:
814-364-9626
Provider Enumeration Date:
11/13/2006