Provider First Line Business Practice Location Address:
1451 FRANKSTOWN RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
JOHNSTOWN
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
15902-1318
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
814-535-6970
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
04/27/2006