Provider First Line Business Practice Location Address:
4210 CRAWFORD AVE STE 1
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
NORTHERN CAMBRIA
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
15714-1342
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
814-948-2643
Provider Business Practice Location Address Fax Number:
814-948-5347
Provider Enumeration Date:
08/26/2025