Provider First Line Business Practice Location Address:
1200 W 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:
16801-2824
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
814-325-0280
Provider Business Practice Location Address Fax Number:
814-826-2241
Provider Enumeration Date:
12/06/2024