Provider First Line Business Practice Location Address:
220 W PLUM ST STE 750
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
EDINBORO
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
16412-2169
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
814-333-5430
Provider Business Practice Location Address Fax Number:
814-314-2901
Provider Enumeration Date:
11/03/2010