Provider First Line Business Practice Location Address:
87 E MAIDEN ST
Provider Second Line Business Practice Location Address:
SUITE 38
Provider Business Practice Location Address City Name:
WASHINGTON
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
15301
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
724-222-8525
Provider Business Practice Location Address Fax Number:
724-222-8545
Provider Enumeration Date:
07/04/2006