Provider First Line Business Practice Location Address:
337 BRUCE V. MOORE BUILDING
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
UNIVERSITY PARK
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
16802-3103
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
814-865-9121
Provider Business Practice Location Address Fax Number:
814-863-1331
Provider Enumeration Date:
11/14/2022