Provider First Line Business Practice Location Address:
1422 LIBERTY ST
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:
16323-1624
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
814-432-2642
Provider Business Practice Location Address Fax Number:
814-437-2750
Provider Enumeration Date:
10/28/2005