Provider First Line Business Practice Location Address:
13 W CHESTNUT 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:
15301-4511
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
724-225-4410
Provider Business Practice Location Address Fax Number:
724-225-4414
Provider Enumeration Date:
03/31/2006