Provider First Line Business Practice Location Address:
97 DELAWARE AVE
Provider Second Line Business Practice Location Address:
SUITE 100
Provider Business Practice Location Address City Name:
UNIONTOWN
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
15401-3137
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
724-434-1808
Provider Business Practice Location Address Fax Number:
724-434-1807
Provider Enumeration Date:
05/28/2006