Provider First Line Business Practice Location Address:
268 W UNION ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SOMERSET
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
15501-1539
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
814-445-6664
Provider Business Practice Location Address Fax Number:
814-443-1108
Provider Enumeration Date:
12/15/2005