Provider First Line Business Practice Location Address:
443 FRYE FARM RD
Provider Second Line Business Practice Location Address:
SUITE 100
Provider Business Practice Location Address City Name:
GREENSBURG
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
15601-2338
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
724-532-5360
Provider Business Practice Location Address Fax Number:
724-879-4033
Provider Enumeration Date:
08/23/2006