Provider First Line Business Practice Location Address:
1450 SCALP AVE STE 302
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
JOHNSTOWN
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
15904-3321
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
814-262-2444
Provider Business Practice Location Address Fax Number:
814-262-2429
Provider Enumeration Date:
06/21/2011