Provider First Line Business Practice Location Address:
ROUTE 56 E
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SPRING CHURCH
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
15686
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
724-478-1141
Provider Business Practice Location Address Fax Number:
724-478-1149
Provider Enumeration Date:
04/09/2007