Provider First Line Business Practice Location Address:
219 W FAIRMONT AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
NEW CASTLE
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
16105-1909
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
724-654-3222
Provider Business Practice Location Address Fax Number:
724-654-9140
Provider Enumeration Date:
01/30/2006