Provider First Line Business Practice Location Address:
1404 MURPHY DR
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
JOHNSTOWN
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
15905-1529
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
814-361-7739
Provider Business Practice Location Address Fax Number:
814-361-7740
Provider Enumeration Date:
10/22/2026