Provider First Line Business Practice Location Address:
220 N FRONT ST # 2
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
PHILIPSBURG
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
16866-1606
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
814-342-6992
Provider Business Practice Location Address Fax Number:
814-342-1770
Provider Enumeration Date:
09/15/2005