Provider First Line Business Practice Location Address:
633 W MAIN ST STE 1
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
MOUNT PLEASANT
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
15666-1846
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
724-542-8864
Provider Business Practice Location Address Fax Number:
724-542-8086
Provider Enumeration Date:
04/01/2006