Provider First Line Business Practice Location Address:
229 N MAIN ST UNIT 5
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
CAMBRIDGE SPRINGS
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
16403-1067
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
814-398-2753
Provider Business Practice Location Address Fax Number:
814-398-2843
Provider Enumeration Date:
07/15/2006