Provider First Line Business Practice Location Address:
461 MAPLEWOOD AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
AMBRIDGE
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
15003-2521
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
724-266-4485
Provider Business Practice Location Address Fax Number:
724-266-1976
Provider Enumeration Date:
05/10/2011