Provider First Line Business Practice Location Address:
277 HOFFMAN AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
WINDBER
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
15963-2369
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
814-467-5505
Provider Business Practice Location Address Fax Number:
814-361-6412
Provider Enumeration Date:
07/21/2005