Provider First Line Business Practice Location Address:
50 E DIVISION ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
NORTH EAST
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
16428-1351
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
814-725-8671
Provider Business Practice Location Address Fax Number:
814-725-9380
Provider Enumeration Date:
05/24/2006