Provider First Line Business Practice Location Address:
119 N 3RD ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
WEST NEWTON
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
15089-1529
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
724-972-3779
Provider Business Practice Location Address Fax Number:
724-872-2935
Provider Enumeration Date:
06/30/2006