Provider First Line Business Practice Location Address:
15 S 8TH ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
INDIANA
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
15701-2776
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
724-349-7388
Provider Business Practice Location Address Fax Number:
724-463-7072
Provider Enumeration Date:
08/29/2005