Provider First Line Business Practice Location Address:
10680 ROUTE 30
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
N HUNTINGDON
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
15642-2048
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
724-861-9455
Provider Business Practice Location Address Fax Number:
724-861-9456
Provider Enumeration Date:
09/02/2005