Provider First Line Business Practice Location Address:
1601 UNION AVE
Provider Second Line Business Practice Location Address:
SUITE B
Provider Business Practice Location Address City Name:
NATRONA HEIGHTS
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
15065-2133
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
724-226-0544
Provider Business Practice Location Address Fax Number:
724-226-2172
Provider Enumeration Date:
12/16/2005