Provider First Line Business Practice Location Address:
1275 S MAIN ST
Provider Second Line Business Practice Location Address:
SUITE 103
Provider Business Practice Location Address City Name:
GREENSBURG
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
15601-5385
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
412-561-7246
Provider Business Practice Location Address Fax Number:
412-235-4011
Provider Enumeration Date:
05/19/2006