Provider First Line Business Practice Location Address:
2107 NORTH FRANKLIN DR.
Provider Second Line Business Practice Location Address:
SUITE 1
Provider Business Practice Location Address City Name:
WASHINGTON
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
15301-5868
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
724-222-3937
Provider Business Practice Location Address Fax Number:
724-222-7570
Provider Enumeration Date:
12/06/2005