Provider First Line Business Practice Location Address:
915 HICKORY ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
HOLLIDAYSBURG
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
16648-2247
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
814-696-4556
Provider Business Practice Location Address Fax Number:
814-696-4561
Provider Enumeration Date:
08/27/2010