Provider First Line Business Practice Location Address:
100 OAKWOOD AVE
Provider Second Line Business Practice Location Address:
SUITE 200
Provider Business Practice Location Address City Name:
STATE COLLEGE
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
16803-2636
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
814-237-4000
Provider Business Practice Location Address Fax Number:
814-272-0256
Provider Enumeration Date:
03/24/2010