Provider First Line Business Practice Location Address:
1422 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:
16323-1624
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
814-437-9750
Provider Business Practice Location Address Fax Number:
814-437-9757
Provider Enumeration Date:
08/31/2006