Provider First Line Business Practice Location Address:
12 WENDEL RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
IRWIN
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
15642-4575
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
724-837-8159
Provider Business Practice Location Address Fax Number:
724-837-7453
Provider Enumeration Date:
03/27/2007