Provider First Line Business Practice Location Address:
205 EASY ST
Provider Second Line Business Practice Location Address:
SUITE 202
Provider Business Practice Location Address City Name:
UNIONTOWN
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
15401-3128
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
724-438-5961
Provider Business Practice Location Address Fax Number:
724-438-5965
Provider Enumeration Date:
01/27/2010