Provider First Line Business Practice Location Address:
840 WOOD ST
Provider Second Line Business Practice Location Address:
CLARION UNIVERSITY - TIPPIN GYMNASIUM
Provider Business Practice Location Address City Name:
CLARION
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
16214-1240
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
814-393-2456
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
05/29/2012