Provider First Line Business Practice Location Address:
4501 ADMIRAL PEARY HIGHWAY
Provider Second Line Business Practice Location Address:
EBENSBURG CENTER
Provider Business Practice Location Address City Name:
EBENSBURG
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
15931-0600
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
814-472-0226
Provider Business Practice Location Address Fax Number:
814-472-8624
Provider Enumeration Date:
08/02/2006