Provider First Line Business Practice Location Address:
1526 N ATHERTON ST STE 200
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:
16803
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
814-237-5220
Provider Business Practice Location Address Fax Number:
412-291-3381
Provider Enumeration Date:
08/31/2006