Provider First Line Business Practice Location Address:
20 N JEFFERSON ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
MOUNT UNION
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
17066-1267
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
814-542-9282
Provider Business Practice Location Address Fax Number:
814-514-1022
Provider Enumeration Date:
08/15/2012