Provider First Line Business Practice Location Address:
911 N FRONT ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
PHILIPSBURG
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
16866-8264
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
814-342-3930
Provider Business Practice Location Address Fax Number:
814-342-3935
Provider Enumeration Date:
07/20/2012