Provider First Line Business Practice Location Address:
197 DUNN STATION RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
PROSPERITY
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
15329-1625
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
724-627-5511
Provider Business Practice Location Address Fax Number:
724-852-1764
Provider Enumeration Date:
09/17/2008