Provider First Line Business Practice Location Address:
235 VAUGHN ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
JOHNSTOWN
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
15906-1533
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
814-270-6050
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
04/17/2024