Provider First Line Business Practice Location Address:
651 S CENTER AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SOMERSET
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
15501-2811
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
814-445-1717
Provider Business Practice Location Address Fax Number:
814-445-1885
Provider Enumeration Date:
03/25/2008