Provider First Line Business Practice Location Address:
12 ARCH ST
Provider Second Line Business Practice Location Address:
BOX 300
Provider Business Practice Location Address City Name:
BROWNSVILLE
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
15417-1611
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
724-785-6558
Provider Business Practice Location Address Fax Number:
724-785-4404
Provider Enumeration Date:
08/15/2006