Provider First Line Business Practice Location Address:
620 N MAIN ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
WASHINGTON
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
15301-3968
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
724-222-1063
Provider Business Practice Location Address Fax Number:
724-222-2245
Provider Enumeration Date:
04/07/2010