Provider First Line Business Practice Location Address:
1022 PHILADELPHIA ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
INDIANA
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
15701-1676
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
724-465-2225
Provider Business Practice Location Address Fax Number:
724-465-2225
Provider Enumeration Date:
10/26/2006