Provider First Line Business Practice Location Address:
105 HIGHWAY STREET AT HUNTINGTON RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
YUKON
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
15698-0201
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
724-722-4466
Provider Business Practice Location Address Fax Number:
724-722-4466
Provider Enumeration Date:
10/02/2006