Provider First Line Business Practice Location Address:
1275 S MAIN ST
Provider Second Line Business Practice Location Address:
SUITE 101
Provider Business Practice Location Address City Name:
GREENSBURG
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
15601-5385
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
724-837-3111
Provider Business Practice Location Address Fax Number:
724-837-3022
Provider Enumeration Date:
10/14/2005