Provider First Line Business Practice Location Address:
146 RECREATION BLDG UNIVERSITY PARK, PA, 16802
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:
16802
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
914-258-7505
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
02/11/2021