Provider First Line Business Practice Location Address:
2480 S GRANDE BLVD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
GREENSBURG
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
15601-8902
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
724-830-4000
Provider Business Practice Location Address Fax Number:
724-830-4074
Provider Enumeration Date:
12/01/2005