Provider First Line Business Practice Location Address:
147E RECREATIONAL HALL
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:
16802
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
814-321-7706
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
06/09/2016