Provider First Line Business Practice Location Address:
700 COLLEGE PLACE
Provider Second Line Business Practice Location Address:
LYCOMING COLLEGE
Provider Business Practice Location Address City Name:
WILLIAMSPORT
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
17701-5192
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
570-321-4271
Provider Business Practice Location Address Fax Number:
570-321-4158
Provider Enumeration Date:
03/06/2007