Provider First Line Business Practice Location Address:
142 ELM ST.
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
CLAYSVILLE
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
15323
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
724-663-4284
Provider Business Practice Location Address Fax Number:
724-663-4284
Provider Enumeration Date:
09/20/2007