Provider First Line Business Practice Location Address:
1001 E WICONISCO AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
TOWER CITY
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
17980-1612
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
717-647-2297
Provider Business Practice Location Address Fax Number:
717-647-2672
Provider Enumeration Date:
06/16/2006