Provider First Line Business Practice Location Address:
180 N FRANKLIN ST STE B
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
COCHRANTON
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
16314-9706
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
814-425-1126
Provider Business Practice Location Address Fax Number:
814-425-9973
Provider Enumeration Date:
07/27/2006