Provider First Line Business Practice Location Address:
1227 WARM SPRINGS AVE
Provider Second Line Business Practice Location Address:
2ND FLOOR SUITE 202
Provider Business Practice Location Address City Name:
HUNTINGDON
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
16652-2350
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
814-643-8478
Provider Business Practice Location Address Fax Number:
814-643-7043
Provider Enumeration Date:
07/01/2013