Provider First Line Business Practice Location Address:
700 5TH ST
Provider Second Line Business Practice Location Address:
SUITE 200
Provider Business Practice Location Address City Name:
WINDBER
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
15963-1313
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
814-539-0798
Provider Business Practice Location Address Fax Number:
814-536-4751
Provider Enumeration Date:
03/23/2009