Provider First Line Business Practice Location Address:
1283 LIBERTY ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
FRANKLIN
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
16323-1333
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
814-337-0000
Provider Business Practice Location Address Fax Number:
866-303-9031
Provider Enumeration Date:
10/31/2008