Provider First Line Business Practice Location Address:
251 7TH ST
Provider Second Line Business Practice Location Address:
STE C204
Provider Business Practice Location Address City Name:
NEW KENSINGTON
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
15068
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
724-339-1633
Provider Business Practice Location Address Fax Number:
724-339-1170
Provider Enumeration Date:
04/28/2006