Provider First Line Business Practice Location Address:
218 W MOODY AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
NEW CASTLE
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
16101-2141
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
724-658-6367
Provider Business Practice Location Address Fax Number:
724-652-1109
Provider Enumeration Date:
06/11/2008