Provider First Line Business Practice Location Address:
VA OUTPATIENT CLINIC
Provider Second Line Business Practice Location Address:
190 WEST PARK AVE, SUITE 8
Provider Business Practice Location Address City Name:
DU BOIS
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
15801
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
814-375-6817
Provider Business Practice Location Address Fax Number:
814-375-0922
Provider Enumeration Date:
07/10/2006