Provider First Line Business Practice Location Address:
42 E MAIDEN ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
WASHINGTON
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
15301-4912
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
724-225-2228
Provider Business Practice Location Address Fax Number:
724-225-5746
Provider Enumeration Date:
04/24/2012