Provider First Line Business Practice Location Address:
3499 BRUMBAUGH RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
NEW ENTERPRISE
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
16664-8820
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
814-766-0124
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
02/11/2016