Provider First Line Business Practice Location Address:
1217 MOUNT PLEASANT RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
GREENSBURG
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
15601-6331
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
724-838-8149
Provider Business Practice Location Address Fax Number:
724-838-8149
Provider Enumeration Date:
04/12/2007