Provider First Line Business Practice Location Address:
108 SAINT JOSEPH STREET
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
CARROLLTOWN
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
15722
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
814-344-8987
Provider Business Practice Location Address Fax Number:
814-344-6287
Provider Enumeration Date:
10/25/2005