Provider First Line Business Practice Location Address:
235 HUMPHREY RD
Provider Second Line Business Practice Location Address:
TWO PINEVIEW PLACE, SUITE 1
Provider Business Practice Location Address City Name:
GREENSBURG
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
15601-4579
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
724-834-8033
Provider Business Practice Location Address Fax Number:
724-834-4290
Provider Enumeration Date:
10/28/2006