Provider First Line Business Practice Location Address:
440 W MAIN ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
MONONGAHELA
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
15063-2565
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
724-258-2650
Provider Business Practice Location Address Fax Number:
724-258-6775
Provider Enumeration Date:
03/22/2006