Provider First Line Business Practice Location Address:
1333 S ALLEN ST STE 3
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:
16801-5944
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
814-231-0130
Provider Business Practice Location Address Fax Number:
814-231-4502
Provider Enumeration Date:
05/30/2025