Provider First Line Business Practice Location Address:
1008 MAPLE AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
NORTHERN CAMBRIA
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
15714-1353
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
814-948-8600
Provider Business Practice Location Address Fax Number:
814-948-8790
Provider Enumeration Date:
07/26/2005