Provider First Line Business Practice Location Address:
8931 ROUTE 30
Provider Second Line Business Practice Location Address:
NORTH HUNTINGDON SQUARE
Provider Business Practice Location Address City Name:
NORTH HUNTINGDON
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
15642
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
724-864-7481
Provider Business Practice Location Address Fax Number:
724-863-7604
Provider Enumeration Date:
07/29/2006