Provider First Line Business Practice Location Address:
417 SABBATH REST RD STE 3
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
ALTOONA
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
16601-7567
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
814-940-8195
Provider Business Practice Location Address Fax Number:
814-940-8816
Provider Enumeration Date:
06/03/2006