Provider First Line Business Practice Location Address:
1703 KATHRYN ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
NEW CUMBERLAND
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
17070
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
717-774-6343
Provider Business Practice Location Address Fax Number:
717-774-7659
Provider Enumeration Date:
10/28/2008