Provider First Line Business Practice Location Address:
1225 SOUTH MAIN ST
Provider Second Line Business Practice Location Address:
WELLINGTON SQUARE SUITE 106
Provider Business Practice Location Address City Name:
GREENSBURG
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
15601
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
724-836-4452
Provider Business Practice Location Address Fax Number:
724-836-1562
Provider Enumeration Date:
02/11/2008