Provider First Line Business Practice Location Address:
2500 OLD ROUTE 220 N
Provider Second Line Business Practice Location Address:
SAM'S CLUB OPTICAL
Provider Business Practice Location Address City Name:
ALTOONA
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
16601-9326
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
814-946-1465
Provider Business Practice Location Address Fax Number:
814-946-1575
Provider Enumeration Date:
05/11/2007