Provider First Line Business Practice Location Address:
102 E ATLANTIC AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
FRANKLIN
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
16323-2364
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
814-437-9111
Provider Business Practice Location Address Fax Number:
814-437-1263
Provider Enumeration Date:
01/23/2007