Provider First Line Business Practice Location Address:
1201 BLAIR STREET
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
HOLLIDAYSBURG
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
16648
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
814-696-0289
Provider Business Practice Location Address Fax Number:
814-695-8241
Provider Enumeration Date:
09/05/2014