Provider First Line Business Practice Location Address:
401 MAGEE AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
PATTON
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
16668-1210
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
814-674-8922
Provider Business Practice Location Address Fax Number:
814-674-5818
Provider Enumeration Date:
02/12/2007