Provider First Line Business Practice Location Address:
310 N 3RD ST UNIT 1
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
YOUNGWOOD
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
15697-1614
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
724-925-2341
Provider Business Practice Location Address Fax Number:
724-925-2386
Provider Enumeration Date:
12/13/2007