Provider First Line Business Practice Location Address:
332 W PLANK RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
ALTOONA
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
16602
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
814-941-5353
Provider Business Practice Location Address Fax Number:
814-941-5039
Provider Enumeration Date:
03/28/2006