Provider First Line Business Practice Location Address:
433 FRYE FARM RD
Provider Second Line Business Practice Location Address:
SUITE #10
Provider Business Practice Location Address City Name:
GREENSBURG
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
15601-7920
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
724-879-4642
Provider Business Practice Location Address Fax Number:
724-879-8381
Provider Enumeration Date:
02/19/2014