Provider First Line Business Practice Location Address:
237 NORTHLAND CTR
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:
16803-2900
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
814-231-8542
Provider Business Practice Location Address Fax Number:
814-235-0838
Provider Enumeration Date:
09/29/2006