Provider First Line Business Practice Location Address:
525 W MAIN ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
MT PLEASANT
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
15666-1833
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
724-613-5211
Provider Business Practice Location Address Fax Number:
724-613-5203
Provider Enumeration Date:
01/19/2012