Provider First Line Business Practice Location Address:
445 SCHOOLHOUSE RD
Provider Second Line Business Practice Location Address:
APPALACHIA IU8
Provider Business Practice Location Address City Name:
JOHNSTOWN
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
15904-2927
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
814-262-7392
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
12/04/2013