Provider First Line Business Practice Location Address:
611 UNIVERSITY DR
Provider Second Line Business Practice Location Address:
STE. 111
Provider Business Practice Location Address City Name:
STATE COLLEGE
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
16801-6552
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
814-234-6060
Provider Business Practice Location Address Fax Number:
814-234-0797
Provider Enumeration Date:
09/20/2007