Provider First Line Business Practice Location Address:
2615 E COLLEGE AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
STATE COLLEGE
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
16801-7512
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
814-308-8155
Provider Business Practice Location Address Fax Number:
814-308-8584
Provider Enumeration Date:
07/01/2010