Provider First Line Business Practice Location Address:
RTE 26 NORTH
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
JAMES CREEK
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
16657
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
814-658-2037
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
07/19/2005