Provider First Line Business Practice Location Address:
327 S MAIN ST
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:
15601-3111
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
724-834-4044
Provider Business Practice Location Address Fax Number:
724-834-5840
Provider Enumeration Date:
11/16/2006