Provider First Line Business Practice Location Address:
505 N 4TH ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
YOUNGWOOD
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
15697-1559
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
724-840-2181
Provider Business Practice Location Address Fax Number:
724-925-1430
Provider Enumeration Date:
01/06/2011