Provider First Line Business Practice Location Address:
401 BROAD ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
JOHNSTOWN
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
15906-2716
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
814-535-6000
Provider Business Practice Location Address Fax Number:
814-248-7902
Provider Enumeration Date:
07/09/2006