Provider First Line Business Practice Location Address:
7829 NATIONAL PIKE
Provider Second Line Business Practice Location Address:
SUITE 1
Provider Business Practice Location Address City Name:
UNIONTOWN
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
15401-5104
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
724-439-1616
Provider Business Practice Location Address Fax Number:
724-439-8782
Provider Enumeration Date:
01/14/2007