Provider First Line Business Practice Location Address:
1402 LIBERY STREET
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
FRANKLIN
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
16323
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
814-432-5121
Provider Business Practice Location Address Fax Number:
814-432-5121
Provider Enumeration Date:
10/23/2006