Provider First Line Business Practice Location Address:
113 W MAIN ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
WEST NEWTON
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
15089-1141
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
724-872-6401
Provider Business Practice Location Address Fax Number:
724-872-9743
Provider Enumeration Date:
05/06/2010