Provider First Line Business Practice Location Address:
4501 ADMIRAL PEARY HIGHWAY
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
EBENSBURG
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
15931
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
814-472-7350
Provider Business Practice Location Address Fax Number:
814-472-8624
Provider Enumeration Date:
10/03/2006