Provider First Line Business Practice Location Address:
102 CHURCH ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
THREE SPRINGS
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
17264
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
814-448-2900
Provider Business Practice Location Address Fax Number:
814-448-2908
Provider Enumeration Date:
08/18/2005