Provider First Line Business Practice Location Address:
1022 A N MAIN ST
Provider Second Line Business Practice Location Address:
AVADA BLDG 2ND FLOOR
Provider Business Practice Location Address City Name:
BUTLER
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
16001
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
724-283-8622
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
11/22/2006