Provider First Line Business Practice Location Address:
137 EAST MAIN ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
MILLHEIM
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
16854
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
814-574-8099
Provider Business Practice Location Address Fax Number:
814-349-2636
Provider Enumeration Date:
12/26/2013