Provider First Line Business Practice Location Address:
2078 SOUTH 6TH STREET
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
INDIANA
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
15701
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
814-938-8554
Provider Business Practice Location Address Fax Number:
814-938-8559
Provider Enumeration Date:
06/10/2013