Provider First Line Business Practice Location Address:
643 MERCHANT STREET
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
AMBRIDGE
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
15003
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
724-266-4400
Provider Business Practice Location Address Fax Number:
724-266-4411
Provider Enumeration Date:
11/01/2006