Provider First Line Business Practice Location Address:
5 S 3RD ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
CLEARFIELD
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
16830-2324
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
814-768-3550
Provider Business Practice Location Address Fax Number:
817-768-7750
Provider Enumeration Date:
07/21/2005