Provider First Line Business Practice Location Address:
1134 LIBERTY ST
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:
16323-1223
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
814-346-1312
Provider Business Practice Location Address Fax Number:
814-346-1312
Provider Enumeration Date:
10/23/2023