Provider First Line Business Practice Location Address:
321 STATE ROUTE 66
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
LEECHBURG
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
15656-8279
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
724-845-6667
Provider Business Practice Location Address Fax Number:
724-845-2533
Provider Enumeration Date:
03/10/2007