Provider First Line Business Practice Location Address:
130 CALIFORNIA RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
BROWNSVILLE
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
15417-9312
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
724-938-3554
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
11/15/2006