Provider First Line Business Practice Location Address:
20881 STATE HWY 198
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SAEGERTOWN
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
16433-6159
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
814-763-2445
Provider Business Practice Location Address Fax Number:
814-763-2108
Provider Enumeration Date:
06/13/2005