Provider First Line Business Practice Location Address:
3865 BRUMBAUGH RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
NEW ENTERPRISE
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
16664-9150
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
814-766-2676
Provider Business Practice Location Address Fax Number:
814-766-2011
Provider Enumeration Date:
08/18/2005