Provider First Line Business Practice Location Address:
222 E PRESQUEISLE ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
PHILIPSBURG
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
16866-1641
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
814-496-9141
Provider Business Practice Location Address Fax Number:
814-826-4555
Provider Enumeration Date:
09/19/2018