Provider First Line Business Practice Location Address:
113 THORNTON RD
Provider Second Line Business Practice Location Address:
SUITE D
Provider Business Practice Location Address City Name:
BROWNSVILLE
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
15417-9607
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
724-785-2853
Provider Business Practice Location Address Fax Number:
724-785-4361
Provider Enumeration Date:
11/01/2006