Provider First Line Business Practice Location Address:
ROUTE 51 & JANET STREET
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
PERRYOPOLIS
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
15473
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
724-736-7415
Provider Business Practice Location Address Fax Number:
724-736-7416
Provider Enumeration Date:
06/29/2006