Provider First Line Business Practice Location Address:
1205 E MAHANOY ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
MAHANOY CITY
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
17948-3006
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
520-906-8494
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
07/18/2006