Provider First Line Business Practice Location Address:
1111 FRANKLIN ST
Provider Second Line Business Practice Location Address:
STE 030
Provider Business Practice Location Address City Name:
JOHNSTOWN
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
15905-4330
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
814-539-6797
Provider Business Practice Location Address Fax Number:
814-535-8400
Provider Enumeration Date:
06/13/2005