Provider First Line Business Practice Location Address:
841 HOSPITAL ROAD
Provider Second Line Business Practice Location Address:
SUITE 2300 MARC S TUCKER DO FACOS
Provider Business Practice Location Address City Name:
INDIANA
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
15701
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
724-463-1512
Provider Business Practice Location Address Fax Number:
724-463-1541
Provider Enumeration Date:
02/08/2006