Provider First Line Business Practice Location Address:
518 WESTERN AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
IRWIN
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
15642
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
724-864-3106
Provider Business Practice Location Address Fax Number:
724-864-3107
Provider Enumeration Date:
12/21/2006