Provider First Line Business Practice Location Address:
2121 OLD GATESBURG RD
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:
16803-2290
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
814-231-7277
Provider Business Practice Location Address Fax Number:
814-231-1582
Provider Enumeration Date:
06/08/2009