Provider First Line Business Practice Location Address:
380 W CHESTNUT ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
WASHINGTON
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
15301-4657
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
724-228-0782
Provider Business Practice Location Address Fax Number:
724-228-7585
Provider Enumeration Date:
06/16/2010