Provider First Line Business Practice Location Address:
255 HUMPHREY RD.
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
GREENSBURG
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
15601
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
724-448-0095
Provider Business Practice Location Address Fax Number:
724-845-0923
Provider Enumeration Date:
06/14/2011