Provider First Line Business Practice Location Address:
4133 MEDICAL CENTER DR
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
BROAD TOP
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
16621-9001
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
814-635-2916
Provider Business Practice Location Address Fax Number:
814-635-2918
Provider Enumeration Date:
07/17/2006