Provider First Line Business Practice Location Address:
1 DALE AVE
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:
16323-2301
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
814-432-9753
Provider Business Practice Location Address Fax Number:
814-432-9781
Provider Enumeration Date:
12/15/2006