Provider First Line Business Practice Location Address:
200 S. MILL ST.
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
RIDGWAY
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
15853
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
814-772-0722
Provider Business Practice Location Address Fax Number:
814-772-6934
Provider Enumeration Date:
11/06/2009