Provider First Line Business Practice Location Address:
95 LEONARD AVE
Provider Second Line Business Practice Location Address:
SUITE 201
Provider Business Practice Location Address City Name:
WASHINGTON
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
15301-3368
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
724-225-9320
Provider Business Practice Location Address Fax Number:
724-225-4299
Provider Enumeration Date:
11/14/2006