Provider First Line Business Practice Location Address:
3528 ROUTE 119 HWY S
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
HOMER CITY
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
15748-1594
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
724-479-2231
Provider Business Practice Location Address Fax Number:
724-479-2813
Provider Enumeration Date:
04/19/2006