Provider First Line Business Practice Location Address:
12 N 4TH ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
YOUNGWOOD
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
15697-1306
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
724-925-6360
Provider Business Practice Location Address Fax Number:
724-925-6360
Provider Enumeration Date:
09/02/2006