Provider First Line Business Practice Location Address:
159 WATERDAM RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
MC MURRAY
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
15317-2576
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
724-942-1511
Provider Business Practice Location Address Fax Number:
724-942-1513
Provider Enumeration Date:
03/05/2008