Provider First Line Business Practice Location Address:
211 PLUM ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
ELIZABETH
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
15037-1517
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
412-384-7068
Provider Business Practice Location Address Fax Number:
412-384-2805
Provider Enumeration Date:
08/18/2006