Provider First Line Business Practice Location Address:
3344 ROUTE 130
Provider Second Line Business Practice Location Address:
SUITE A
Provider Business Practice Location Address City Name:
HARRISON CITY
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
15636-1238
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
724-744-3660
Provider Business Practice Location Address Fax Number:
724-744-3815
Provider Enumeration Date:
11/02/2007