Provider First Line Business Practice Location Address:
433 FRYE FARM RD STE 5
Provider Second Line Business Practice Location Address:
CENTRAL MEDICAL ARTS BLDG.
Provider Business Practice Location Address City Name:
GREENSBURG
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
15601-7920
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
724-539-3750
Provider Business Practice Location Address Fax Number:
724-539-3751
Provider Enumeration Date:
08/22/2008