Provider First Line Business Practice Location Address:
110 FRANKLIN ST STE 300
Provider Second Line Business Practice Location Address:
CENTRAL PARK COMPLEX
Provider Business Practice Location Address City Name:
JOHNSTOWN
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
15901-1830
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
814-364-2161
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
04/08/2014