Provider First Line Business Practice Location Address:
373 FRYE FARM RD
Provider Second Line Business Practice Location Address:
SUITE ONE
Provider Business Practice Location Address City Name:
GREENSBURG
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
15601-6479
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
724-537-5570
Provider Business Practice Location Address Fax Number:
724-537-2774
Provider Enumeration Date:
12/06/2006