Provider First Line Business Practice Location Address:
301 SALT ST
Provider Second Line Business Practice Location Address:
STE 1
Provider Business Practice Location Address City Name:
SALTSBURG
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
15681-1122
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
724-639-3043
Provider Business Practice Location Address Fax Number:
724-639-3343
Provider Enumeration Date:
01/18/2006