Provider First Line Business Practice Location Address:
609 NATIONAL PIKE E
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
BROWNSVILLE
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
15417-9603
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
724-366-7175
Provider Business Practice Location Address Fax Number:
724-938-7838
Provider Enumeration Date:
10/02/2006