Provider First Line Business Practice Location Address:
23 S GALLATIN AVE
Provider Second Line Business Practice Location Address:
SUITE #1
Provider Business Practice Location Address City Name:
UNIONTOWN
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
15401-3541
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
724-430-1411
Provider Business Practice Location Address Fax Number:
724-430-0630
Provider Enumeration Date:
01/08/2007