Provider First Line Business Practice Location Address:
470 JOHNSON RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
WASHINGTON
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
15301-8944
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
724-223-3816
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
12/15/2014