Provider First Line Business Practice Location Address:
255 NORTHLAND CTR
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
STATE COLLEGE
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
16803-2903
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
814-237-1837
Provider Business Practice Location Address Fax Number:
814-237-9313
Provider Enumeration Date:
07/07/2006