Provider First Line Business Practice Location Address:
534 W OTTERMAN ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
GREENSBURG
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
15601-2113
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
724-837-7700
Provider Business Practice Location Address Fax Number:
734-837-7793
Provider Enumeration Date:
02/28/2006