Provider First Line Business Practice Location Address:
11 SHENANGO RD STE 1
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
NEW CASTLE
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
16105-1177
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
724-657-1881
Provider Business Practice Location Address Fax Number:
724-657-9178
Provider Enumeration Date:
04/13/2011