Provider First Line Business Practice Location Address:
188 INDUSTRIAL PARK RD STE B
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
EBENSBURG
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
15931-4125
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
814-419-8211
Provider Business Practice Location Address Fax Number:
814-846-5945
Provider Enumeration Date:
05/12/2019