Provider First Line Business Practice Location Address:
100 HOSPITAL AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
DU BOIS
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
15801-1440
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
814-371-2200
Provider Business Practice Location Address Fax Number:
814-375-3384
Provider Enumeration Date:
09/20/2006