Provider First Line Business Practice Location Address:
336 BLOOMFIELD ST STE 103
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:
15904-3271
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
814-266-1900
Provider Business Practice Location Address Fax Number:
814-266-4786
Provider Enumeration Date:
02/08/2007