Provider First Line Business Practice Location Address:
2 WILSON AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
WASHINGTON
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
15301-3335
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
724-228-4550
Provider Business Practice Location Address Fax Number:
724-228-3746
Provider Enumeration Date:
06/29/2012