Provider First Line Business Practice Location Address:
1569 SMITH TOWNSHIP STATE ROAD
Provider Second Line Business Practice Location Address:
SUITE 2
Provider Business Practice Location Address City Name:
ATLASBURG
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
15004
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
724-947-9999
Provider Business Practice Location Address Fax Number:
740-264-4376
Provider Enumeration Date:
11/28/2006