Provider First Line Business Practice Location Address:
605 N CHURCH ST
Provider Second Line Business Practice Location Address:
SUITE C
Provider Business Practice Location Address City Name:
MOUNT PLEASANT
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
15666-1000
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
724-547-5566
Provider Business Practice Location Address Fax Number:
724-547-0910
Provider Enumeration Date:
07/19/2006