Provider First Line Business Practice Location Address:
RT 136 AND JANYCE DRIVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
GREENSBURG
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
15601
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
724-850-8501
Provider Business Practice Location Address Fax Number:
724-850-8510
Provider Enumeration Date:
10/11/2005