Provider First Line Business Practice Location Address:
40 HUFF AVENUE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
GREENSBURG
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
15601-5317
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
724-836-3960
Provider Business Practice Location Address Fax Number:
724-836-2876
Provider Enumeration Date:
10/03/2006