Provider First Line Business Practice Location Address:
197 W MAIN ST REAR
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
UNIONTOWN
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
15401-5535
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
724-437-1129
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
01/11/2007