Provider First Line Business Practice Location Address:
1227 WARM SPRINGS AVE
Provider Second Line Business Practice Location Address:
J. C. BLAIR MEDICAL BUILDING, STE. 301
Provider Business Practice Location Address City Name:
HUNTINGDON
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
16652-2300
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
814-643-8574
Provider Business Practice Location Address Fax Number:
814-643-8659
Provider Enumeration Date:
05/28/2006