Provider First Line Business Practice Location Address:
368 HEINZ CAMP RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
PORTERSVILLE
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
16051-3906
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
724-368-9417
Provider Business Practice Location Address Fax Number:
724-368-9654
Provider Enumeration Date:
10/02/2008