Provider First Line Business Practice Location Address:
1225 S MAIN ST
Provider Second Line Business Practice Location Address:
SUITE 105
Provider Business Practice Location Address City Name:
GREENSBURG
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
15601-5370
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
724-837-8282
Provider Business Practice Location Address Fax Number:
724-837-8485
Provider Enumeration Date:
04/17/2006