Provider First Line Business Practice Location Address:
20397 ROUTE 19N LANDMARK II BUILDING
Provider Second Line Business Practice Location Address:
SUITE 120
Provider Business Practice Location Address City Name:
CRANBERRY TWP
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
16066-6133
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
724-742-1818
Provider Business Practice Location Address Fax Number:
724-742-1828
Provider Enumeration Date:
05/03/2013