Provider First Line Business Practice Location Address:
104 E MAIN ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
MAHAFFEY
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
15757-6338
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
814-277-5560
Provider Business Practice Location Address Fax Number:
814-277-5560
Provider Enumeration Date:
02/19/2007