Provider First Line Business Practice Location Address:
1150 WASHINGTON RD
Provider Second Line Business Practice Location Address:
SUITE 109
Provider Business Practice Location Address City Name:
WASHINGTON
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
15301-9683
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
724-228-0650
Provider Business Practice Location Address Fax Number:
724-228-0716
Provider Enumeration Date:
10/11/2006