Provider First Line Business Practice Location Address:
5 S 2ND ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
MASONTOWN
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
15461-1538
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
724-583-0744
Provider Business Practice Location Address Fax Number:
724-583-0350
Provider Enumeration Date:
03/17/2008