Provider First Line Business Practice Location Address:
1112 S MILL ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
NEW CASTLE
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
16101-4629
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
724-658-4564
Provider Business Practice Location Address Fax Number:
724-657-8563
Provider Enumeration Date:
09/28/2016