Provider First Line Business Practice Location Address:
122 N WASHINGTON ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
EVANS CITY
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
16033-1063
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
724-538-3667
Provider Business Practice Location Address Fax Number:
724-538-3826
Provider Enumeration Date:
03/31/2007