Provider First Line Business Practice Location Address:
5840 RT 981 S
Provider Second Line Business Practice Location Address:
SUITE 104
Provider Business Practice Location Address City Name:
LATROBE
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
15650
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
724-539-7685
Provider Business Practice Location Address Fax Number:
724-539-7086
Provider Enumeration Date:
04/07/2006