Provider First Line Business Practice Location Address:
433 FRYE FARM RD
Provider Second Line Business Practice Location Address:
SUITE 7
Provider Business Practice Location Address City Name:
GREENSBURG
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
15601-6480
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
724-539-0505
Provider Business Practice Location Address Fax Number:
724-532-2430
Provider Enumeration Date:
08/11/2006