Provider First Line Business Practice Location Address:
1949 HEATHVILLE OHL RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SUMMERVILLE
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
15864-4419
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
814-400-4716
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
10/19/2026