Provider First Line Business Practice Location Address:
444 E COLLEGE AVE
Provider Second Line Business Practice Location Address:
STE 310
Provider Business Practice Location Address City Name:
STATE COLLEGE
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
16801-5558
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
814-238-6380
Provider Business Practice Location Address Fax Number:
814-238-5923
Provider Enumeration Date:
06/30/2005