Provider First Line Business Practice Location Address:
392 FRANKLIN AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
ALIQUIPPA
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
15001-3708
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
724-203-4669
Provider Business Practice Location Address Fax Number:
724-788-1326
Provider Enumeration Date:
01/26/2011