Provider First Line Business Practice Location Address:
229 S KIMBERLY AVE
Provider Second Line Business Practice Location Address:
SUITE 200
Provider Business Practice Location Address City Name:
SOMERSET
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
15501-2022
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
814-445-3535
Provider Business Practice Location Address Fax Number:
814-445-3245
Provider Enumeration Date:
06/09/2006