Provider First Line Business Practice Location Address:
1227 WARM SPRINGS AVE
Provider Second Line Business Practice Location Address:
SUITE 304
Provider Business Practice Location Address City Name:
HUNTINGDON
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
16652-2300
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
814-643-4663
Provider Business Practice Location Address Fax Number:
814-643-9273
Provider Enumeration Date:
07/28/2006