Provider First Line Business Practice Location Address:
3135 NEW GERMANY RD
Provider Second Line Business Practice Location Address:
SUITE #38
Provider Business Practice Location Address City Name:
EBENSBURG
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
15931-4347
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
814-472-8900
Provider Business Practice Location Address Fax Number:
814-472-9466
Provider Enumeration Date:
12/19/2006