Provider First Line Business Practice Location Address:
550 W COLLEGE AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
PLEASANT GAP
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
16823-7401
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
814-359-3421
Provider Business Practice Location Address Fax Number:
814-359-5898
Provider Enumeration Date:
02/12/2006