Provider First Line Business Practice Location Address:
781 CAMPBELL AVE
Provider Second Line Business Practice Location Address:
SUITE C
Provider Business Practice Location Address City Name:
NEW KENSINGTON
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
15068-4605
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
412-973-3250
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
05/02/2007