Provider First Line Business Practice Location Address:
104 DELAWARE AVE
Provider Second Line Business Practice Location Address:
SUITE 244
Provider Business Practice Location Address City Name:
UNIONTOWN
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
15401-3100
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
724-437-2229
Provider Business Practice Location Address Fax Number:
724-438-6530
Provider Enumeration Date:
08/04/2009