Provider First Line Business Practice Location Address:
1450 SCALP AVE STE 1000
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:
15904-3335
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
814-269-5204
Provider Business Practice Location Address Fax Number:
814-269-5060
Provider Enumeration Date:
02/06/2007