Provider First Line Business Practice Location Address:
2 W MAIN ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
UNIONTOWN
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
15401-3408
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
772-283-1165
Provider Business Practice Location Address Fax Number:
772-463-2301
Provider Enumeration Date:
07/23/2009