Provider First Line Business Practice Location Address:
1620 SOMERSET 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:
15963-1748
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
814-467-9244
Provider Business Practice Location Address Fax Number:
814-467-6796
Provider Enumeration Date:
09/29/2011