Provider First Line Business Practice Location Address:
596 BUCKWHEAT HILL RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
CARROLLTOWN
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
15722-9006
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
814-948-6041
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
07/31/2014