Provider First Line Business Practice Location Address:
604 NORTH MAIN STREET
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
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
724-225-5070
Provider Business Practice Location Address Fax Number:
724-225-5262
Provider Enumeration Date:
10/13/2006