Provider First Line Business Practice Location Address:
3001 JACKS RUN ROAD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
WHITE OAK
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
15131
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
412-672-5220
Provider Business Practice Location Address Fax Number:
412-672-5199
Provider Enumeration Date:
11/28/2006