Provider First Line Business Practice Location Address:
240 S BURROWES ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
STATE COLLEGE
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
16801-4008
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
814-238-4400
Provider Business Practice Location Address Fax Number:
814-238-4112
Provider Enumeration Date:
02/06/2007