Provider First Line Business Practice Location Address:
58 W MAIN ST
Provider Second Line Business Practice Location Address:
2ND FLOOR
Provider Business Practice Location Address City Name:
UNIONTOWN
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
15401-3303
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
724-430-0988
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
10/11/2006