Provider First Line Business Practice Location Address:
530 SOUTH ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
GREENSBURG
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
15601-2775
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
724-830-8527
Provider Business Practice Location Address Fax Number:
724-850-3145
Provider Enumeration Date:
03/27/2006