Provider First Line Business Practice Location Address:
1 BRADDOCK AVENUE
Provider Second Line Business Practice Location Address:
STE B & C, HUNTINGDON PLACE
Provider Business Practice Location Address City Name:
MOUNT PLEASANT
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
15666-1458
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
724-547-6090
Provider Business Practice Location Address Fax Number:
724-547-6091
Provider Enumeration Date:
06/11/2006