Provider First Line Business Practice Location Address:
240 S FOURTH ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
MINERSVILLE
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
17954
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
570-544-4845
Provider Business Practice Location Address Fax Number:
570-544-8036
Provider Enumeration Date:
02/01/2006