Provider First Line Business Practice Location Address:
90 WEST CHESTNUT ST.
Provider Second Line Business Practice Location Address:
STE. 510
Provider Business Practice Location Address City Name:
WASHINGTON
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
15301
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
724-222-0112
Provider Business Practice Location Address Fax Number:
724-222-5126
Provider Enumeration Date:
01/30/2007