Provider First Line Business Practice Location Address:
655 JEFFERSON AVE
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:
15301-4118
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
724-225-8145
Provider Business Practice Location Address Fax Number:
724-225-4934
Provider Enumeration Date:
07/02/2007