Provider First Line Business Practice Location Address:
1011 OLD SALEM RD STE 208
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
GREENSBURG
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
15601-1096
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
724-838-7790
Provider Business Practice Location Address Fax Number:
724-838-9599
Provider Enumeration Date:
01/03/2007