Provider First Line Business Practice Location Address:
311 S ALLEN ST
Provider Second Line Business Practice Location Address:
STE. 3
Provider Business Practice Location Address City Name:
STATE COLLEGE
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
16801-4857
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
814-441-4484
Provider Business Practice Location Address Fax Number:
814-234-0395
Provider Enumeration Date:
05/01/2007